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General NPI Number Information
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NPI Number | 1235298241
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Entity Type | Organization
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Legal Business Name | ANESTHESIA OF ENID LLC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 600 S MONROE ST
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City | ENID
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State | OK
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Zip | 73701-7211
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Country | US
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Telephone | 580-402-2261
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6112
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City | ENID
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State | OK
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Zip | 73702-6112
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Country | US
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Telephone | 580-402-2261
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Fax | 405-758-5582
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MONTE MATLI
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Credential | MD
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Telephone | 580-402-2261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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