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General NPI Number Information
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NPI Number | 1134241797
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Entity Type | Organization
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Legal Business Name | ALLIED SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 5874 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74146-6425
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Country | US
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Telephone | 918-893-6201
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Fax | 918-893-6202
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Provider Business Mailing Address
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Address Line | 5874 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74146-6425
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Country | US
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Telephone | 918-893-6201
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Fax | 918-893-6202
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Authorized Official
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Title or Position | OWNER
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Name | KEVEN PARTIN
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Credential | CFA
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Telephone | 918-695-0167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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