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NPI Code Detail

MEDICARE: REGAL DORN NEUROMONITORING LLC

MEDICARE: REGAL DORN NEUROMONITORING 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
1246ZS0410XSurgical Technologist

General Provider Information

NPI Number : 1346803681
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGAL DORN NEUROMONITORING LLC
Provider Business Mailing Address
First Line : PO BOX 268953
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73126-8953
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1715 S BALTIMORE AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4807
Country : US
Telephone Number : 918-895-7680
Fax Number :
Authorized Official
Title or Position : BILLING ASSOCIATE
Name : VALERIE SHEHAN
Credential :
Telephone Number : 918-895-7680
Provider Enumeration Date : 04/22/2019
Last Update Date : 04/22/2019

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Directions to “REGAL DORN NEUROMONITORING LLC ” Practice Location

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