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General NPI Number Information
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NPI Number | 1013991835
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Entity Type | Organization
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Legal Business Name | E R ASSOCIATES INC
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1524 W OKMULGEE ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-6741
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Country | US
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Telephone | 918-682-5397
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Fax | 918-682-2663
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Provider Business Mailing Address
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Address Line | 1524 W OKMULGEE ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-6741
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Country | US
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Telephone | 918-682-5397
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Fax | 918-682-2663
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | DR. JEFF D ENDSLEY
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Credential | DO
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Telephone | 918-682-5397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 3027
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License Number State | OK
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