Organization
SOUTHERN PLAINS ORTHOPAEDIC AND SPORTS MEDICINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL BIZZLE DO (OWNER)
(918) 453-0023
Entity
Organization
Contact information
Practice address
1504 E SHAWNEE CIRCLE, TAHLEQUAH, OK 74464
(918) 453-0023
(918) 453-0027
Mailing address
1504 E SHAWNEE CIRCLE, TAHLEQUAH, OK 74464
(918) 453-0023
(918) 453-0027
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3240
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0516550001
CIGNA GOVERNMENT SERVICES
OK
01
—
200033584
RAILROAD MEDICARE
OK
Enumeration date
11/21/2006
Last updated
05/29/2008
Update your record
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