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General NPI Number Information
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NPI Number | 1932240041
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT OF TULSA P C
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 6802 S OLYMPIA AVE SUITE 100
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City | TULSA
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State | OK
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Zip | 74132-1823
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Country | US
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Telephone | 918-447-9300
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Fax | 918-447-9308
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Provider Business Mailing Address
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Address Line | 6802 S OLYMPIA AVE SUITE 100
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City | TULSA
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State | OK
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Zip | 74132-1823
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Country | US
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Telephone | 918-447-9300
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Fax | 918-447-9308
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Authorized Official
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Title or Position | OWNER
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Name | DR. C SCOTT ANTHONY
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Credential | DO
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Telephone | 918-447-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 2940
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License Number State | OK
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