Organization
OLYMPIA ANESTHESIA, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW ANTHONY WENGER MD (PRESIDENT)
(918) 809-9464
Entity
Organization
Contact information
Practice address
6901 S OLYMPIA AVE, TULSA, OK 74132-1843
(918) 664-9892
(918) 664-2521
Mailing address
PO BOX 21050, DEPT OA2015, TULSA, OK 74121
(918) 809-9464
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070080A
—
OK
01
—
611105300
DEPT OF LABOR
—
Enumeration date
07/30/2006
Last updated
05/20/2021
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