Basic Information
| Provider Information | |||||||||
| NPI: | 1154575546 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEUROSURGICAL SERVICES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 535 NW 9TH ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058132600 | ||||||||
| FaxNumber: | 4058132633 | ||||||||
| Practice Location | |||||||||
| Address1: | 535 NW 9TH ST | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731021070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058132600 | ||||||||
| FaxNumber: | 4058132633 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2008 | ||||||||
| LastUpdateDate: | 11/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | BARRY | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4058132600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEUROSURGICAL SERVICES PLLC | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.