OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION PC NPI 1427279561

NPI Information

OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC is a pain medicine physical medicine rehabilitation in Broken Arrow, OK. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. OKLAHOMA PHYSICAL MEDICINE AND REHABILITATION, PC NPI is 1427279561. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1621 S EUCALYPTUS AVE
SUITE 204
BROKEN ARROW, OK
ZIP 74012-940
Phone: (918) 252-7952

The provider's authorized official is Timothy G Pettingell .
The authorized official title is Physician and has the following contact phone number (918) 252-7952.

The CLIA number assigned to this NPI record is 37D1072715 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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