| NPI | 1124005533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MICHAEL MCMULLEN President/Owner 405-749-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: OK 17646) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2014-09-19 |