Organization
OKLAHOMA CHRONIC PAIN SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMAD S ATTALLAH-WASIF MD (OWNER AND PRESIDENT)
(774) 473-9119
Entity
Organization
Contact information
Practice address
10124 S SHERIDAN RD STE B, TULSA, OK 74133-6742
(774) 473-9119
Mailing address
10124 S SHERIDAN RD, STE B, TULSA, OK 74133
(774) 473-9119
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
31431
OK
208VP0000X
Pain Medicine Physician
31431
OK
208VP0014X
Interventional Pain Medicine Physician
31431
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200593270A
—
OK
Enumeration date
05/23/2017
Last updated
07/07/2017
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