Healthcare Provider Details

I. General information

NPI: 1457379760
Provider Name (Legal Business Name): MARION R HARGER IX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N DEWEY AVE
OKLAHOMA CITY OK
73103-2609
US

IV. Provider business mailing address

1111 N DEWEY AVE
OKLAHOMA CITY OK
73103-2609
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-9146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR0025029
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: