Organization
NES OKLAHOMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLAKEMAN (PROVIDER ENROLLMENT)
(469) 557-6183
Entity
Organization
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-3321
Mailing address
7300 STATE HIGHWAY 121 STE 370-374, MCKINNEY, TX 75070-1987
(469) 557-6183
(469) 640-6671
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200008720A
—
OK
Enumeration date
11/15/2005
Last updated
10/25/2024
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