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TAHLEQUAH ORTHOPEDIC SURGERY SERVICES LLC NPI 1780808980


NPI Information

NPI: 1780808980
Provider Name: TAHLEQUAH ORTHOPEDIC SURGERY SERVICES, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1373 E. BOONE ST.
SUITE 3401
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 456-6848
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TAHLEQUAH ORTHOPEDIC SURGERY SERVICES, LLC is a specialist in Tahlequah, 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. TAHLEQUAH ORTHOPEDIC SURGERY SERVICES, LLC NPI is 1780808980. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1373 E. BOONE ST.
SUITE 3401
TAHLEQUAH, OK
ZIP 74464-379
Phone: (918) 456-6848
Fax: (918) 456-1150

The provider's authorized official is Christopher Sarrett Deloache .
The authorized official title is Owner and has the following contact phone number (918) 456-6848.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 8/30/2012.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist207X00000XOKLAHOMAYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1448746259004OTHEROKLAHOMABLUE CROSS AND BLUE SHIEL
25296460001MEDICARE NSCOKLAHOMA
3200076030AMEDICAIDOKLAHOMA
4100522065MEDICARE PINOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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