Basic Information
| Provider Information | |||||||||
| NPI: | 1326266750 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIONEER PLAINS EMERGENCY PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 815 SOUTH PALAFOX STREET | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325025937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004447009 | ||||||||
| FaxNumber: | 8003053233 | ||||||||
| Practice Location | |||||||||
| Address1: | 520 MEDICAL DRIVE | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | GUYMON | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803386515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | EXEC VICE PRES EMCARE PHYS PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 8004447009 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.