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General NPI Number Information
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NPI Number | 1780789362
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Entity Type | Organization
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Legal Business Name | CHILDREN & ADOLESCENT MEDICAL SERVICES INC.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 8803 S. 101ST E. AVE. SUITE 200
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-307-2273
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Fax | 918-307-0273
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Provider Business Mailing Address
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Address Line | 8803 S. 101ST E. AVE. SUITE 200
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-307-2273
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Fax | 918-307-0273
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JANELL P CYRUS
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Credential |
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Telephone | 918-307-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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