MEDICARE: NES OKLAHOMA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1093161754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NES OKLAHOMA INC

Provider Business Mailing Address
First Line	:	PO BOX 198962
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8962
Country	:	US
Telephone Number	:	800-377-8721
Fax Number	:	304-697-1155

Provider Business Practice Location Address
First Line	:	911 HOSPITAL DR
Second Line	:
City	:	SAYRE
State	:	OK
Zip	:	73662-1206
Country	:	US
Telephone Number	:	580-928-5541
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JENNIFER MOORE
Credential	:
Telephone Number	:	800-242-6711

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	05/11/2016

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Directions to “NES OKLAHOMA INC ” Practice Location

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