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NPI Code Detail

MEDICARE: CENTRAL OKC ANESTHESIA, PLLC

MEDICARE: CENTRAL OKC ANESTHESIA, PLLC
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

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DE9437OTHEROKMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891729885
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL OKC ANESTHESIA, PLLC
Provider Business Mailing Address
First Line : PO BOX 26706
Second Line : SEC 90
City : OKLAHOMA CITY
State : OK
Zip : 73126-0706
Country : US
Telephone Number : 405-775-9350
Fax Number : 405-775-9360
Provider Business Practice Location Address
First Line : 4317 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134-1720
Country : US
Telephone Number : 405-755-6240
Fax Number : 405-752-1819
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : MELENIE NACHIMSON
Credential :
Telephone Number : 405-775-9350
Provider Enumeration Date : 07/10/2006
Last Update Date : 06/29/2011

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Directions to “CENTRAL OKC ANESTHESIA, PLLC ” Practice Location

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