MEDICARE: COSMETIC SURGERY CENTER OF ARDMORE LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1093792681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COSMETIC SURGERY CENTER OF ARDMORE LLC

Provider Business Mailing Address
First Line	:	818 16TH AVE NW
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-1818
Country	:	US
Telephone Number	:	580-226-2171
Fax Number	:	580-226-2772

Provider Business Practice Location Address
First Line	:	818 16TH AVE NW
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-1818
Country	:	US
Telephone Number	:	580-226-2171
Fax Number	:	580-226-2772

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HARRY GALOOB
Credential	:	M.D.
Telephone Number	:	580-226-2171

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	02/19/2009

Similar Medicare Providers

1982096152 — DR. LYNDSI LUANNE BEARD D.C.
Practice Location Address:

804 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-223-5900
Practice Fax: 580-223-5565

1659763837 — DIB CHIROPRACTIC & WELLNESS PLLC
Practice Location Address:

804 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-223-5900
Practice Fax:

1437136116 — DR. HARRY GALOOB M.D.
Practice Location Address:

818 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-226-2171
Practice Fax: 580-226-2772

1285611160 — DR. JAMES FORRESTAL DO
Practice Location Address:

830 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-226-5120
Practice Fax: 580-223-1003

1154363075 — DR. JOHN L SJULIN DDS
Practice Location Address:

808 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-226-2822
Practice Fax: 580-226-7561

1619985371 — RICHARD BROOK EDMONDS DDS
Practice Location Address:

806 16TH AVE NW
ARDMORE, OK
73401-1818

Practice Phone: 580-223-5514
Practice Fax: 580-223-5908

Directions to “COSMETIC SURGERY CENTER OF ARDMORE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.