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1750597449 NPI number — OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.

NPI Number: 1750597449
Health Care Provider/Practitioner: OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.

Information about “1750597449” NPI (OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.) exists in 1750597449 in HTML format HTML  |  1750597449 in plain Text format TXT  |  1750597449 in PDF (Portable Document Format) PDF  |  1750597449 in an XML format XML  formats.

NPI Number : 1750597449 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750597449",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OKLAHOMA LITHOTRIPTER ASSOCIATES, L.C.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5401 N PORTLAND AVE STE 640",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OKLAHOMA CITY",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73112-2130",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "405-604-4160",
    "MailingAddressFaxNumber": "405-604-4053",
    "FirstLinePracticeLocationAddress": "5401 N PORTLAND AVE STE 650",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OKLAHOMA CITY",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73112-2081",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-604-4160",
    "PracticeLocationAddressFaxNumber": "405-604-4053",
    "EnumerationDate": "05/16/2007",
    "LastUpdateDate": "07/21/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BURCHETT",
    "AuthorizedOfficialFirstName": "STEWART",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "EXECUTIVE DIR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "405-604-4183",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QA1903X",
          "TaxonomyName": "Ambulatory Surgical Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QA1903X",
          "TaxonomyName": "Ambulatory Surgical Clinic/Center",
          "LicenseNumber": "0086",
          "LicenseNumberStateCode": "OK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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