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General NPI Number Information
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NPI Number | 1871575068
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Entity Type | Organization
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Legal Business Name | NES OKLAHOMA, INC.
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 105 WALL ST
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City | POTEAU
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State | OK
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Zip | 74953-4433
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Country | US
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Telephone | 918-635-3400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 198962
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City | ATLANTA
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State | GA
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Zip | 30384-8962
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Country | US
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Telephone | 800-377-8721
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Fax | 304-697-1155
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Authorized Official
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Title or Position | CFO
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Name | JENNIFER MOORE
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Credential |
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Telephone | 415-435-4591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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