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General NPI Number Information
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NPI Number | 1992841811
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Entity Type | Organization
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Legal Business Name | GENERAL SURGERY GROUP, PLLC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 RENAISSANCE BLVD 2ND FLOOR
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City | EDMOND
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State | OK
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Zip | 73013-3023
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Country | US
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Telephone | 405-359-2468
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Fax | 405-286-4952
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Provider Business Mailing Address
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Address Line | PO BOX 20007
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City | OKLAHOMA CITY
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State | OK
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Zip | 73156-0007
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Country | US
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Telephone | 405-936-8200
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Fax | 405-286-4952
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | GREGORY F WALTON
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Credential | M.D.
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Telephone | 405-936-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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