Organization
SOUTHWEST PATHOLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELVIN J. VAN BOVEN D.O. (PRESIDENT)
(918) 582-0001
Entity
Organization
Contact information
Practice address
8803 S 101ST E AVE, TULSA, OK 74133
(918) 582-0001
(917) 582-0003
Mailing address
PO BOX 26303, OKLAHOMA CITY, OK 73126-0303
(918) 582-0001
(917) 582-0003
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
06/27/2008
Last updated
06/12/2020
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