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General NPI Number Information
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NPI Number | 1487909131
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Entity Type | Organization
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Legal Business Name | ELITE SURGICAL FIRST ASSISTANTS, LLC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 414 SE WASHINGTON BLVD # 273
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2428
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Country | US
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Telephone | 918-440-4377
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Fax | 918-335-7962
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Provider Business Mailing Address
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Address Line | 414 SE WASHINGTON BLVD # 273
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City | BARTLESVILLE
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State | OK
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Zip | 74006-2428
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Country | US
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Telephone | 918-440-4377
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Fax | 918-335-7962
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DEE ANNE YOWAISH
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Credential | CST/CSFA
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Telephone | 918-440-4377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | OOF798
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License Number State | OK
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