Individual
PAUL G BIZZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
327 HICKORY DR, TAHLEQUAH, OK 74464-5115
(918) 453-0023
(918) 453-0023
Mailing address
PO BOX 1799, TAHLEQUAH, OK 74465-1799
(918) 453-0023
(918) 453-0023
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3240
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0516550001
CIGNA GOVERNMENT SERVICES
OK
01
—
200033584
RAILROAD MEDICARE
OK
Enumeration date
09/01/2006
Last updated
11/19/2013
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