Organization
OKKY OEI MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN A SORENSEN (ADMINISTRATOR)
(602) 431-1152
Entity
Organization
Contact information
Practice address
2801 N 33RD AVE STE 200, PHOENIX, AZ 85009-1445
(602) 415-1111
(602) 415-1417
Mailing address
PO BOX 52022, PHOENIX, AZ 85072-2022
(602) 431-1152
(602) 431-2149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13583
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
13583
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13583
LICENSE
AZ
Enumeration date
05/26/2017
Last updated
05/26/2017
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