Organization
PHOENIX PHYSICIAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL DEAN ORCUTT M.D. (PRESIDENT)
(405) 751-4664
Entity
Organization
Contact information
Practice address
4300 W MEMORIAL RD, ER DEPT., OKLAHOMA CITY, OK 73120-8304
(405) 752-3733
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100742040A
—
OK
01
—
175187000
DEPT OF LABOR
OK
Enumeration date
03/23/2006
Last updated
02/12/2010
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