Organization
CENTRAL OKC ANESTHESIA, PLLC
Active
Organization
CENTRAL OKC ANESTHESIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELENIE NACHIMSON (CREDENTIALING SPECIALIST)
(405) 775-9350
Entity
Organization
Contact information
Practice address
4317 W MEMORIAL RD, OKLAHOMA CITY, OK 73134-1720
(405) 755-6240
(405) 752-1819
Mailing address
PO BOX 26706, SEC 90, OKLAHOMA CITY, OK 73126-0706
(405) 775-9350
(405) 775-9360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200075030A
—
OK
01
—
DE9437
MEDICARE RR
OK
Enumeration date
07/10/2006
Last updated
06/29/2011
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