| NPI | 1124413075 |
|---|---|
| Doing Business As | OSU-AJ PREMIER PEDIATRICS OF MUSKOGEE |
| Entity Type | Organization |
| Authorized Contact | ERIC POLAK Vice President For Admin/Finance 918-561-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2016-03-02 |