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General NPI Number Information
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NPI Number | 1366822298
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Entity Type | Organization
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Legal Business Name | OKLAHOMA PAIN PHYSICIANS PC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 13301 N MERIDIAN AVE BLDG 600
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-9369
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Country | US
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Telephone | 405-606-8950
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Fax | 405-755-9113
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Provider Business Mailing Address
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Address Line | 13301 N MERIDIAN AVE BLDG 600
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-9369
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Country | US
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Telephone | 405-606-8950
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Fax | 405-755-9113
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAFAEL JUSTIZ III
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Credential | M.D.
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Telephone | 405-606-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 27480
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License Number State | OK
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