Basic Information
| Provider Information | |||||||||
| NPI: | 1902897556 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MORNINGSTAR EMERGENCY PHYSICIANS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 SW 104TH ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731399040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053782197 | ||||||||
| FaxNumber: | 4053782196 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 SW 104TH ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731399040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053782197 | ||||||||
| FaxNumber: | 4053782196 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ASKINS | ||||||||
| AuthorizedOfficialFirstName: | DALE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4053782197 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | CN3548 | 01 | OK | RAILROAD MEDICARE | OTHER |