Individual
MARK STEPHEN PASCALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 230-9000
(405) 230-9157
Mailing address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 230-9000
(405) 230-9175
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16037
OK
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
16037
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100037780A
—
OK
01
—
200040269
RAILROAD MEDICARE
OK
Enumeration date
07/14/2005
Last updated
08/09/2019
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