NORTHWEST INSTITUTE OF SPORTS MEDICINE NPI 1760509079

NPI Information

NORTHWEST INSTITUTE OF SPORTS MEDICINE is a specialist in Oklahoma City, OK. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. NORTHWEST INSTITUTE OF SPORTS MEDICINE NPI is 1760509079. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4200 W MEMORIAL RD
SUITE 1001
OKLAHOMA CITY, OK
ZIP 73120-350
Phone: (405) 787-7678
Fax: (405) 751-3367

The provider's authorized official is Gene Lester Muse .
The authorized official title is Physician and has the following contact phone number (405) 787-7678.

The CLIA number assigned to this NPI record is 37D0699747 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/23/2007 and was last updated on 6/19/2009.

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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