| NPI | 1790044980 |
|---|---|
| Doing Business As | OSU-AJ EASTERN OKLAHOMA ENT |
| Entity Type | Organization |
| Authorized Contact | ERIC POLAK Vice President For Admin/Finance 918-561-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2016-04-05 |