Organization
GUY E. GROOMS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI COLLEEN STEVENSON (OFFICE MANAGER)
(918) 682-7717
Entity
Organization
Contact information
Practice address
209 S 36TH ST, MUSKOGEE, OK 74401-5043
(918) 682-7717
(918) 682-9434
Mailing address
209 S 36TH ST, MUSKOGEE, OK 74401-5043
(918) 682-7717
(918) 682-9434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20183
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213780A
—
OK
Enumeration date
08/09/2010
Last updated
08/09/2010
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