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General NPI Number Information
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NPI Number | 1083655823
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE SPECIALISTS INC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 3366 NW EXPRESSWAY SUITE 400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4462
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Country | US
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Telephone | 405-702-1300
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Fax | 405-702-1280
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Provider Business Mailing Address
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Address Line | 3366 NW EXPRESSWAY STE 400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4416
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS SERVICES
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Name | DIANA J MOCK
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Credential |
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Telephone | 405-767-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State |
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