Organization
SOUTHERN ANESTHESIA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D MACKEY CRNA (PRESIDENT)
(405) 501-4244
Entity
Organization
Contact information
Practice address
419 W GRAY ST, NORMAN, OK 73069-7117
(405) 809-4200
(405) 364-5379
Mailing address
419 W GRAY ST, NORMAN, OK 73069-7117
(405) 809-4200
(405) 364-5379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0085277
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200095850A
—
OK
Enumeration date
08/30/2006
Last updated
09/11/2009
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