Basic Information
| Provider Information | |||||||||
| NPI: | 1770891475 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA ASSOCIATES OF OKLAHOMA PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6465 S YALE AVE | ||||||||
| Address2: | SUITE 1002 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741367802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187286010 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4200 E SKELLY DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741353247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187286010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2010 | ||||||||
| LastUpdateDate: | 04/29/2011 | ||||||||
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| AuthorizedOfficialLastName: | STANTON | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 9187286010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.