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General NPI Number Information
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NPI Number | 1063535755
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Entity Type | Organization
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Legal Business Name | ROBERT PATZKOWSKY & JAMES TURRENTINE
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 800 ISABEL
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City | ARDMORE
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State | OK
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Zip | 73401-5118
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Country | US
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Telephone | 580-223-5432
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Fax | 580-223-6076
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Provider Business Mailing Address
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Address Line | P.O. BOX 309
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City | ARDMORE
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State | OK
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Zip | 73402-0309
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Country | US
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Telephone | 580-223-5432
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Fax | 580-223-6076
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Authorized Official
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Title or Position | OWNER-PHYSICIAN
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Name | JAMES R TURRENTINE
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Credential | D.O.
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Telephone | 580-223-5432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 1537
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 1222
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License Number State | OK
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