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General NPI Number Information
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NPI Number | 1922350719
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Entity Type | Organization
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Legal Business Name | ALLERGY ARTS OF OKLAHOMA PLLC
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 3300 NW 56TH ST STE 100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4538
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Country | US
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Telephone | 405-760-7721
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Fax | 405-212-4885
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Provider Business Mailing Address
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Address Line | 3300 NW 56TH ST STE 100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4538
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Country | US
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Telephone | 405-760-7721
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Fax | 405-212-4885
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARK GREGORY LIPE
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Credential | M.D.
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Telephone | 405-760-7721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 207K00
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License Number State | OK
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