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Organization

OKLAHOMA PAIN PHYSICIANS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAFAEL JUSTIZ III M.D. (OWNER)
(405) 606-8950
Entity
Organization

Contact information

Practice address
13301 N MERIDIAN AVE, BLDG 600, OKLAHOMA CITY, OK 73120-9369
(405) 606-8950
(405) 755-9113
Mailing address
13301 N MERIDIAN AVE, BLDG 600, OKLAHOMA CITY, OK 73120-9369
(405) 606-8950
(405) 755-9113

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
27480
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200109590A
OK
01
27480
OKLAHOMA MEDICAL LICENSE
OK
Enumeration date
06/05/2015
Last updated
03/07/2023
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