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General NPI Number Information
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NPI Number | 1831227206
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Entity Type | Organization
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Legal Business Name | EAR NOSE & THROAT CENTER INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 1101 S BELMONT AVE SUITE 101
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City | OKMULGEE
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State | OK
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Zip | 74447-6315
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Country | US
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Telephone | 918-756-9271
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Fax | 918-756-4695
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Provider Business Mailing Address
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Address Line | 1101 S BELMONT AVE SUITE 101
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City | OKMULGEE
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State | OK
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Zip | 74447-6315
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Country | US
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Telephone | 918-756-9271
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Fax | 918-756-4695
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HANI RAMZI MALATI
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Credential | MD
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Telephone | 918-756-9271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 14985
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License Number State | OK
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