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General NPI Number Information
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NPI Number | 1528029196
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICAL SERVICES GROUP, PA
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 1001 TOWSON AVE ER DEPT.
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City | FORT SMITH
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State | AR
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Zip | 72901-4921
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Country | US
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Telephone | 479-441-5011
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Fax | 405-749-4561
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Provider Business Mailing Address
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Address Line | 4401 W MEMORIAL RD SUITE 121
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City | OKLAHOMA CITY
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State | OK
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Zip | 73134-1785
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Country | US
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Telephone | 405-751-4664
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Fax | 405-749-4561
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ALAN HORAN
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Credential | M.D.
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Telephone | 479-441-5011
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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 |
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License Number State |
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