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General NPI Number Information
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NPI Number | 1487424859
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Entity Type | Organization
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Legal Business Name | PREMIER PARADOX INC
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 3524 NW 56TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4518
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Country | US
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Telephone | 405-657-3120
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Fax | 405-657-3122
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Provider Business Mailing Address
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Address Line | 3524 NW 56TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4518
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Country | US
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Telephone | 405-657-3120
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Fax | 405-657-3122
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Authorized Official
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Title or Position | OWNER
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Name | MARK WOODSON
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Credential | MD
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Telephone | 405-657-3120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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