Organization
SOUTHWESTERN NEUROSURGERY PHYSICIANS LLC
Active
Other names
Southwestern Neurosciences
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON O'SHAUGHNESSY (CEO)
(580) 531-4600
Entity
Organization
Contact information
Practice address
5604 SW LEE BLVD, SUITE 357, LAWTON, OK 73505-9681
(580) 531-4600
(580) 531-6405
Mailing address
5604 SW LEE BLVD, SUITE 357, LAWTON, OK 73505-9681
(580) 531-4600
(580) 531-6405
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
23774
OK
2084N0400X
Neurology Physician
26013
OK
208600000X
Surgery Physician
25895
OK
208600000X
Surgery Physician
25956
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200035200A
—
OK
05
—
200051010A
—
OK
05
—
200199360A
—
OK
Enumeration date
06/11/2006
Last updated
08/23/2008
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