Organization
FOUNDATION SURGERY AFFILIATE OF NORTHWEST OKLAHO
Active
Other names
Foundation Surgery Center of Oklahoma
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A NEWMAN (EVP AND CHIEF OPERATING OFFICER)
(405) 608-1706
Entity
Organization
Contact information
Practice address
14000 N. PORTLAND AVENUE, SUITE 100, OKLAHOMA CITY, OK 73134-4004
(405) 936-8100
(405) 748-5962
Mailing address
14000 N. PORTLAND AVENUE, SUITE 203, OKLAHOMA CITY, OK 73134-4004
(405) 608-1700
(405) 608-1800
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0077
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077
LICENSE
OK
05
—
200077650 A
—
OK
Enumeration date
04/21/2006
Last updated
04/06/2012
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