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Organization
CIMARRON AMBULATORY SERVICES, LLC
Active
Organization
CIMARRON AMBULATORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GALLIART (VP BUSINESS DEVELOPMENT)
(405) 372-1480
Entity
Organization
Contact information
Practice address
1323 W 6TH AVE, STILLWATER, OK 74074-4306
(405) 742-5300
(405) 742-4990
Mailing address
1323 W 6TH AVE, STILLWATER, OK 74074-4306
(405) 742-5300
(405) 742-4990
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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