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General NPI Number Information
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NPI Number | 1003127952
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Entity Type | Organization
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Legal Business Name | OHH PHYSICIANS SOUTH, LLC
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 5200 E I 240 SERVICE RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-2607
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Country | US
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Telephone | 405-628-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 E I 240 SERVICE RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-2607
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Country | US
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Telephone | 405-628-6000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARK KLAKULAK
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Credential |
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Telephone | 405-608-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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