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General NPI Number Information
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NPI Number | 1548682644
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Entity Type | Organization
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Legal Business Name | LADD C. ATKINS, D.O., P.L.L.C
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 9641 RIVERSIDE PKWY A
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City | TULSA
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State | OK
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Zip | 74137-7441
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Country | US
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Telephone | 918-518-5522
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 328
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City | CHECOTAH
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State | OK
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Zip | 74426-0328
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Country | US
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Telephone | 918-473-2233
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | LADD C ATKINS
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Credential | D.O.
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Telephone | 918-518-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4362
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License Number State | OK
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