MEDICARE: OKLAHOMA SPINE SURGERY CENTER PHYSICIANS GROUP

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
1	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1932038379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA SPINE SURGERY CENTER PHYSICIANS GROUP

Provider Business Mailing Address
First Line	:	13313 N MERIDIAN AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8316
Country	:	US
Telephone Number	:	405-849-6979
Fax Number	:	405-849-9264

Provider Business Practice Location Address
First Line	:	13313 N MERIDIAN AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8316
Country	:	US
Telephone Number	:	405-849-6979
Fax Number	:	405-849-9264

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TERRA PAPPE
Credential	:
Telephone Number	:	405-849-6979

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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