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Organization
BROKEN ARROW PAIN SPECIALIST, LLC
Active
Organization
BROKEN ARROW PAIN SPECIALIST, LLC
Active
Other names
Oklahoma Pain Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
IAN KELLEY (SOLE MEMBER)
(918) 633-0447
Entity
Organization
Contact information
Practice address
2028 MAHANEY AVE, TAHLEQUAH, OK 74464-5783
(918) 992-6050
(833) 763-2349
Mailing address
2028 MAHANEY AVE, TAHLEQUAH, OK 74464-5783
(918) 992-6050
(833) 763-2349
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
07/22/2026
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