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General NPI Number Information
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NPI Number | 1821051566
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Entity Type | Organization
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Legal Business Name | CENTRAL STATES ORTHOPEDIC SPECIALISTS, INC.
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 6585 S YALE AVE 200
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City | TULSA
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State | OK
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Zip | 74136-8384
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Country | US
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Telephone | 918-481-2767
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Fax | 918-481-7611
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Provider Business Mailing Address
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Address Line | 6585 S YALE AVE SUITE 200
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City | TULSA
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State | OK
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Zip | 74136-8384
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Country | US
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Telephone | 918-481-2767
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Fax | 918-481-7611
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | SARAH FOX
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Credential |
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Telephone | 918-481-7616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | OK
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