| NPI | 1306899620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE T BREWER Director Provider Enrollment 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OK 2252) |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-03-14 |