Healthcare Provider Details

I. General information

NPI: 1811176134
Provider Name (Legal Business Name): JOHN NELSON PARSONS CST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 E 13TH ST STE 400
TULSA OK
74104-4431
US

IV. Provider business mailing address

12001 E 114TH PL N
COLLINSVILLE OK
74021-5726
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: