Organization
SOUTHWEST PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLY RATLIFF (OFFICE MANAGER)
(405) 631-2379
Entity
Organization
Contact information
Practice address
937 SW 89TH ST, SUITE A, OKLAHOMA CITY, OK 73139-9231
(405) 631-2379
Mailing address
937 SW 89TH ST, SUITE A, OKLAHOMA CITY, OK 73139-9231
(405) 631-2379
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100735080B
—
OK
Enumeration date
12/02/2006
Last updated
06/08/2012
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