Basic Information
| Provider Information | |||||||||
| NPI: | 1063489458 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OKLAHOMA CENTER FOR ORTHOPAEDIC & MULTI-SPECIALTY SURGERY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8100 S WALKER AVE | ||||||||
| Address2: | BLDG C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731399404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056026500 | ||||||||
| FaxNumber: | 4056026589 | ||||||||
| Practice Location | |||||||||
| Address1: | 8100 S WALKER AVE | ||||||||
| Address2: | BLDG C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731399404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056026500 | ||||||||
| FaxNumber: | 4056026589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2006 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOORE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICER/AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 4056026500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2347 | OK | Y | Hospitals | General Acute Care Hospital |
No ID Information.