Healthcare Provider Details

I. General information

NPI: 1861694192
Provider Name (Legal Business Name): HORSE & BUGGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 E 51ST ST STE 100
TULSA OK
74135-7468
US

IV. Provider business mailing address

5505 E 51ST ST SUITE 100
TULSA OK
74135-7468
US

V. Phone/Fax

Practice location:
  • Phone: 918-270-1115
  • Fax:
Mailing address:
  • Phone: 918-270-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number12810
License Number StateOK

VIII. Authorized Official

Name: MRS. PAULA L DUNCAN
Title or Position: PRESIDENT
Credential:
Phone: 918-270-1115