Organization
PJW MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT TIBBS JR. M.D. (PRESIDENT)
(405) 996-2694
Entity
Organization
Contact information
Practice address
4 NE 10TH ST, #465, OKLAHOMA CITY, OK 73104-1402
(405) 996-2694
Mailing address
4 NE 10TH ST, #465, OKLAHOMA CITY, OK 73104-1402
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
03/29/2016
Last updated
03/23/2017
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