Organization
BARTLESVILLE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY S MOONEY (ADMINISTRATOR)
(918) 331-2807
Entity
Organization
Contact information
Practice address
230 SE HOWARD AVE, BARTLESVILLE, OK 74006-2203
(918) 331-2800
(918) 331-2801
Mailing address
230 SE HOWARD AVE, BARTLESVILLE, OK 74006-2203
(918) 331-2800
(918) 331-2801
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0069
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100756840A
—
OK
01
—
700522075
MEDICARE PTAN OR BILLING NUMBER
OK
Enumeration date
02/24/2006
Last updated
03/25/2013
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