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General NPI Number Information
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NPI Number | 1578749065
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Entity Type | Organization
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Legal Business Name | OKLAHOMA SURGICAL HOSPITAL, LLC
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 2408 E 81ST ST STE 900
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City | TULSA
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State | OK
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Zip | 74137-4217
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Country | US
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Telephone | 918-477-5071
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Fax | 918-477-5978
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Provider Business Mailing Address
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Address Line | 2408 E 81ST ST STE 900
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City | TULSA
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State | OK
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Zip | 74137-4217
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Country | US
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Telephone | 918-477-5071
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Fax | 918-477-5978
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Authorized Official
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Title or Position | CEO
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Name | RICK FERGUSON
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Credential |
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Telephone | 918-477-5049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2350
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License Number State | OK
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