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Organization

JEFFREY M. CALAVA D.O., INC

Active
Other names
Specialty Pain Management Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY M CALAVA D.O. (CEO)
(918) 481-6494
Entity
Organization

Contact information

Practice address
6802 S OLYMPIA AVE, STE 250, TULSA, OK 74132-1827
(918) 481-6494
(918) 481-6726
Mailing address
6802 S OLYMPIA AVE, STE 250, TULSA, OK 74132-1827
(918) 481-6494
(918) 481-6726

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3179
OK
261QM2500X
Medical Specialty Clinic/Center
3179
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050056583
RAILROAD MEDICARE
OK
05
100176380A
OK
05
200260790A
OK
01
483768838002
BCBS
OK
01
800522531
MEDICARE ID
OK
01
DG6124
RAILROAD MEDICARE
OK
Enumeration date
11/09/2006
Last updated
11/10/2009
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