Organization
TETON ANESTHESIA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A JOHNSON CRNA (PRESIDENT)
(580) 225-2469
Entity
Organization
Contact information
Practice address
1705 W 2ND ST, ELK CITY, OK 73644-4455
(580) 225-2511
Mailing address
419 W GRAY ST, NORMAN, OK 73069-7117
(405) 329-7300
(405) 364-5379
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200108210A
—
OK
01
—
DG7306
RR MEDICARE
OK
Enumeration date
10/20/2006
Last updated
07/07/2015
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