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NPI Code Detail

MEDICARE: COLON AND RECTAL SURGERY OF OKLAHOMA, P.C.

MEDICARE: COLON AND RECTAL SURGERY OF OKLAHOMA, P.C.
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
1208C00000XColon & Rectal Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1880522025OTHEROKMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134257231
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLON AND RECTAL SURGERY OF OKLAHOMA, P.C.
Provider Business Mailing Address
First Line : 3433 NW 56TH ST
Second Line : SUITE 760
City : OKLAHOMA CITY
State : OK
Zip : 73112-4461
Country : US
Telephone Number : 405-948-0640
Fax Number : 405-948-1753
Provider Business Practice Location Address
First Line : 3433 NW 56TH ST
Second Line : SUITE 760
City : OKLAHOMA CITY
State : OK
Zip : 73112-4461
Country : US
Telephone Number : 405-948-0640
Fax Number : 405-948-1753
Authorized Official
Title or Position : PRESIDENT
Name : CHRIS M. DAVIS
Credential : M.D.
Telephone Number : 405-948-0640
Provider Enumeration Date : 03/01/2007
Last Update Date : 06/30/2010

Similar Medicare Providers

1649279779 — DAVID W VANHOOSER MD
Practice Location Address:
3433 NW 56TH ST STE 760
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-951-4345
Practice Fax: 405-951-4392
1457374936 — CHRIS MYRON DAVIS M.D.
Practice Location Address:
3433 NW 56TH ST , SUITE 740
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-948-0640
Practice Fax: 405-948-1753
1861635898 — MARSHALL TERRY BELL M.D.
Practice Location Address:
3433 NW 56TH ST STE 760
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-951-4345
Practice Fax: 405-951-4392
1538540935 — TRENTON KINNEAR MD
Practice Location Address:
3433 NW 56TH ST STE 760
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-951-4345
Practice Fax: 405-951-4392
1740749696 — STEPHANIE L VANHOOSER
Practice Location Address:
3433 NW 56TH ST STE 760
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-951-4345
Practice Fax: 405-951-4392
1306510169 — SHELBY MARIE FOGLER
Practice Location Address:
3433 NW 56TH ST STE 760
OKLAHOMA CITY, OK
73112-4461
Practice Phone: 405-951-4345
Practice Fax:

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