Organization
BROKEN ARROW PAIN SPECIALIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LADD ATKINS DO (OWNER)
(918) 361-4284
Entity
Organization
Contact information
Practice address
1129 S ASPEN AVE, BROKEN ARROW, OK 74012-4859
(539) 367-1253
(539) 367-3311
Mailing address
1129 S ASPEN AVE, BROKEN ARROW, OK 74012-4859
(539) 367-1253
(539) 367-3311
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200121490A
—
OK
Enumeration date
09/21/2022
Last updated
09/21/2022
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