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NPI Code Detail

MEDICARE: MR. ROCKY ALLEN ARRASMITH PA

MEDICARE: MR. ROCKY ALLEN ARRASMITH PA
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
1363AM0700XMedical Physician Assistant541OK

General Provider Information

NPI Number : 1841216520
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROCKY ALLEN ARRASMITH PA
Provider Business Mailing Address
First Line : 619 N MAIN ST BLDG D
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-4431
Country : US
Telephone Number : 918-682-0222
Fax Number : 918-682-0221
Provider Business Practice Location Address
First Line : 619 N MAIN ST BLDG D
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-4431
Country : US
Telephone Number : 918-682-0222
Fax Number : 918-682-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 11/12/2015

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