Individual
PAUL S ERBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S MONROE ST, ENID, OK 73701-7211
(580) 233-3843
(580) 548-1484
Mailing address
PO BOX 5096, ENID, OK 73702-5096
(580) 233-3843
(580) 548-1484
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
16411
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003480A
—
OK
01
—
300006050
RAILROAD MC
OK
01
—
731440959
TAX PAYER ID NUMBER
OK
01
—
788007
FIRST HEALTH
OK
01
—
A0001
TRICARE
OK
Enumeration date
10/23/2006
Last updated
10/06/2011
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