Organization
COLON AND RECTAL SURGERY OF OKLAHOMA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS M. DAVIS M.D. (PRESIDENT)
(405) 948-0640
Entity
Organization
Contact information
Practice address
3433 NW 56TH ST, SUITE 760, OKLAHOMA CITY, OK 73112-4461
(405) 948-0640
(405) 948-1753
Mailing address
3433 NW 56TH ST, SUITE 760, OKLAHOMA CITY, OK 73112-4461
(405) 948-0640
(405) 948-1753
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100748380A
—
OK
01
—
880522025
MEDICARE PTAN
OK
Enumeration date
03/01/2007
Last updated
06/30/2010
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