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General NPI Number Information
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NPI Number | 1730376351
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Entity Type | Organization
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Legal Business Name | OKLAHOMA ORTHOPAEDIC SPECIALITES PC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 4205 MCAULEY BLVD SUITE 301
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-9391
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Country | US
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Telephone | 405-751-2828
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Fax | 405-751-1253
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Provider Business Mailing Address
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Address Line | PO BOX 21725
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City | OKLAHOMA CITY
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State | OK
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Zip | 73156-1725
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Country | US
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Telephone | 405-751-2828
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Fax | 405-751-1253
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Authorized Official
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Title or Position | DOCTOR
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Name | J PATRICK LIVINGSTON
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Credential | MD
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Telephone | 405-751-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 10712
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License Number State | OK
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