Organization
EDMOND HOSPITALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LAVERTY (VICE PRESIDENT)
(615) 372-5068
Entity
Organization
Contact information
Practice address
1 S BRYANT AVE, EDMOND, OK 73034-6309
(405) 359-5370
(405) 359-5357
Mailing address
3 MARYLAND FARMS, SUITE 250, BRENTWOOD, TN 37027-5005
(615) 372-5068
(866) 829-2199
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199760A
—
OK
Enumeration date
07/31/2007
Last updated
11/27/2013
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