| NPI | 1699104232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA G FOX Manager 405-607-5920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2015-06-22 |