Organization
OKLAHOMA CARDIOVASCULAR ASSOCIATES. PC
Active
Other names
Oklahoma Cardiovascular Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S KLAKULAK (CFO)
(405) 608-3800
Entity
Organization
Contact information
Practice address
4050 W MEMORIAL RD, THIRD FLOOR, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-3838
Mailing address
4050 W MEMORIAL RD, THIRD FLOOR, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-3838
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
OK
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
OK
207RI0011X
Interventional Cardiology Physician
—
OK
207RP1001X
Pulmonary Disease Physician
—
OK
207UN0901X
Nuclear Cardiology Physician
—
OK
208600000X
Surgery Physician
—
OK
2086S0129X
Vascular Surgery Physician
—
OK
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746160A
—
OK
01
—
CD6448
RRMDR
OK
Enumeration date
11/10/2005
Last updated
05/21/2010
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