Organization
SYNERGY HOSPITALIST GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE J BURDEN (ADMINISTRATOR)
(918) 331-1090
Entity
Organization
Contact information
Practice address
226 SE DEBELL AVE, BLDG. A, BARTLESVILLE, OK 74006-2343
(918) 331-1090
Mailing address
PO BOX 3347, TULSA, OK 74101-3347
(918) 331-1090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17649
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094660A
—
OK
01
—
900522531
MEDICARE PTAN
OK
Enumeration date
09/20/2006
Last updated
07/20/2011
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