Organization
MEDICAL CENTER PAIN CLINIC, LLC
Active
Organization
MEDICAL CENTER PAIN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY MOON (PRACTICE ADMINISTRATOR)
(405) 605-8280
Entity
Organization
Contact information
Practice address
1226 N SHARTEL AVE SUITE 300, OKLAHOMA CITY, OK 73103
(405) 232-8003
Mailing address
1226 N SHARTEL AVE SUITE 300, OKLAHOMA CITY, OK 73103
(405) 232-8003
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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