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Organization
NORTHEAST OKLAHOMA PHYSICIAN NETWORK INC
Active
Organization
NORTHEAST OKLAHOMA PHYSICIAN NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD FERGUSON (CEO)
(918) 477-5049
Entity
Organization
Contact information
Practice address
1130 E LANSING ST, BROKEN ARROW, OK 74012-2429
(918) 258-9990
(918) 994-4277
Mailing address
2408 E 81ST ST, STE 300, TULSA, OK 74137-4200
(918) 477-5049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
04/04/2012
Last updated
06/19/2012
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