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General NPI Number Information
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NPI Number | 1245432095
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Entity Type | Organization
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Legal Business Name | SPECTRUM MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2225 SW 59TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-7026
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Country | US
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Telephone | 405-688-7700
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Fax | 405-688-7702
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Provider Business Mailing Address
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Address Line | 2225 SW 59TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-7026
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Country | US
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Telephone | 405-688-7700
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Fax | 405-688-7702
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Authorized Official
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Title or Position | FAMILY PRACTICE PHYSICIAN
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Name | DR. HAMID MAHMOOD
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Credential | M.D.
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Telephone | 405-688-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 23361
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License Number State | OK
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