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General NPI Number Information
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NPI Number | 1245256486
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Entity Type | Organization
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Legal Business Name | BROKEN ARROW ORTHOPEDICS INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 06/09/2017
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Provider Practice Location Address
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Address Line | 10507 E 91ST ST STE 350
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City | TULSA
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State | OK
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Zip | 74133-5598
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Country | US
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Telephone | 918-451-3000
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Fax | 918-451-2700
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Provider Business Mailing Address
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Address Line | 10507 EAST 91ST ST SUITE 350
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City | TULSA
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State | OK
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Zip | 74133-5598
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Country | US
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Telephone | 918-451-3000
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Fax | 918-451-2700
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARRETT EDWARD WATTS
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Credential | M.D.
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Telephone | 918-451-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 17528
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License Number State | OK
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