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General NPI Number Information
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NPI Number | 1871769067
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Entity Type | Organization
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Legal Business Name | OBSTETRICAL ANESTHESIA OF ENID
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 600 S MONROE ST
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City | ENID
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State | OK
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Zip | 73701-7211
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Country | US
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Telephone | 580-233-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 626 DEER RUN
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City | ENID
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State | OK
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Zip | 73703-3426
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Country | US
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Telephone | 580-242-3003
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Fax | 580-237-6174
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN LYNN PHILLIPS
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Credential | DO
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Telephone | 580-242-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1982
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License Number State | OK
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