Healthcare Provider Details

I. General information

NPI: 1790490183
Provider Name (Legal Business Name): 918 ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2023
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 E 103RD ST STE 133
TULSA OK
74133-7027
US

IV. Provider business mailing address

PO BOX 4736
TULSA OK
74159-0736
US

V. Phone/Fax

Practice location:
  • Phone: 918-921-6939
  • Fax:
Mailing address:
  • Phone: 918-630-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN KRAHENBUHL
Title or Position: MEMBER
Credential: DO
Phone: 918-630-2665