Organization
MVB ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA LYNNE VANBEBBER MSN, CRNA (PRESIDENT)
(580) 651-7468
Entity
Organization
Contact information
Practice address
520 MEDICAL DR, GUYMON, OK 73942-4438
(580) 338-3113
(580) 338-4230
Mailing address
634 NE 20TH ST, GUYMON, OK 73942-3035
(580) 651-7468
(580) 338-4230
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200100820A
—
OK
Enumeration date
12/11/2006
Last updated
09/03/2008
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