Organization
SOUTHERN OKLAHOMA ANESTHESIOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOYCE R COLEMAN MD (OWNER)
(580) 272-0485
Entity
Organization
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 421-1160
Mailing address
PO BOX 1907, ADA, OK 74821-1907
(580) 272-0485
(580) 332-5750
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9156
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099490-A
—
OK
Enumeration date
06/07/2010
Last updated
06/07/2010
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