Organization
SOUTHEASTERN OKLAHOMA NEUROSCIENCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBALL N PRATT MD (PHYSICIAN)
(580) 272-0018
Entity
Organization
Contact information
Practice address
520 N MONTE VISTA ST, STE C, ADA, OK 74820-4674
(580) 272-0018
(580) 272-0657
Mailing address
PO BOX 1405, ADA, OK 74821
(580) 272-0018
(580) 272-0657
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
04/01/2008
Last updated
09/12/2008
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