Organization
NEUROSURGERY CENTER OF SOUTHWEST OKLAHOMA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN K. OFORI-KWAKYE M.D. (PRESIDENT)
(580) 353-6000
Entity
Organization
Contact information
Practice address
3201 W GORE BLVD, LAWTON, OK 73505-6378
(580) 353-6000
(580) 353-0800
Mailing address
3201 W GORE BLVD, LAWTON, OK 73505-6378
(580) 353-6000
(580) 353-0800
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
21457
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000050A
—
OK
01
—
OKA103466
PTAN
OK
Enumeration date
07/29/2010
Last updated
06/07/2012
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