# SOUTHWEST PATHOLOGY ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902068265
- **Authorized official:** DR. MELVIN J. VAN BOVEN D.O. (PRESIDENT)
- **Authorized official phone:** (918) 582-0001

## Contact information

- **Practice address:** 8803 S 101ST E AVE, TULSA, OK 74133
- **Practice address phone:** (918) 582-0001
- **Practice address fax:** (917) 582-0003
- **Mailing address:** PO BOX 26303, OKLAHOMA CITY, OK 73126-0303
- **Mailing address phone:** (918) 582-0001
- **Mailing address fax:** (917) 582-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2008
- **Last updated:** 06/12/2020