Basic Information
| Provider Information | |||||||||
| NPI: | 1982732640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VIETH | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | J | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3601 N MAY AVE # AV3 | ||||||||
| Address2: | STE C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731126641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056045613 | ||||||||
| FaxNumber: | 4056013750 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 S MONROE | ||||||||
| Address2: | |||||||||
| City: | ENID | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802332300 | ||||||||
| FaxNumber: | 5805481298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246X00000X | 59 | OK | Y | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Cardiovascular |
No ID Information.