Organization
NES OKLAHOMA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE (CFO)
(415) 435-4591
Entity
Organization
Contact information
Practice address
105 WALL ST, POTEAU, OK 74953-4433
(918) 635-3400
Mailing address
PO BOX 198962, ATLANTA, GA 30384-8962
(800) 377-8721
(304) 697-1155
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182744002
—
AR
05
—
200008720B
—
OK
01
—
9R061
AR BCBS
AR
01
—
DA0105
RR MEDICARE
—
Enumeration date
11/15/2005
Last updated
04/30/2013
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