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NPI Code Detail

MEDICARE: ANESTHESIA ASSOCIATES OF MUSKOGEE, PC

MEDICARE: ANESTHESIA ASSOCIATES OF MUSKOGEE, PC
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1750515722
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANESTHESIA ASSOCIATES OF MUSKOGEE, PC
Provider Business Mailing Address
First Line : 4421 W OKMULGEE ST
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-4651
Country : US
Telephone Number : 918-645-7938
Fax Number :
Provider Business Practice Location Address
First Line : 2900 N MAIN ST
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-4078
Country : US
Telephone Number : 918-645-7938
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RONALD S STEVENS
Credential : DO
Telephone Number : 918-682-2833
Provider Enumeration Date : 05/06/2009
Last Update Date : 05/06/2009

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