Organization
DURANT HMA, INC.
Active
Other names
MCSO Physician Services
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PARRY ESQ (SR. VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization
Contact information
Practice address
1800 W UNIVERSITY BLVD, DURANT, OK 74701-3006
(580) 924-3080
Mailing address
1800 W UNIVERSITY BLVD, PO BOX 1207, DURANT, OK 74701-3006
(580) 924-3080
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370014-880
BC BS OKLAHOMA
OK
05
—
1006966610D
—
OK
Enumeration date
04/24/2007
Last updated
02/18/2009
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