Organization
SOUTHWESTERN PATHOLOGY ASSOCIATES
Active
Parent organization
SOUTHWESTERN PATHOLOGY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWESTERN PATHOLOGY ASSOCIATES
Authorized official
DR. MICHAEL C MCGINNIS M.D. (DIRECTOR OF PATHOLOGY/OWNER)
(580) 536-0021
Entity
Organization
Contact information
Practice address
4704 NW MOTIF MANOR BLVD, SUITE 7, LAWTON, OK 73505-4800
(580) 536-0021
(580) 536-1024
Mailing address
4704 NW MOTIF MANOR BLVD, SUITE 7, LAWTON, OK 73505-4800
(580) 536-0021
(580) 536-1024
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19385
OK
291U00000X
Clinical Medical Laboratory
19385
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051543
—
NJ
01
—
2359692000
AMERIHEALTH
NJ
05
—
2738769
—
NY
01
—
5001537
GHI
NJ
01
—
DD1085
RR MEDICARE
—
Enumeration date
09/19/2007
Last updated
04/20/2008
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