Bozalis, John Russell

Bozalis, John Russell is an individual health care provider with primary practice located at 750 Ne 13Th St , Oklahoma City OK 73104-5051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Bozalis, John Russell can be contacted via phone (405) 235-0040.

Contact Information

Primary practice address
750 Ne 13Th St Oklahoma City OK 73104-5051
Phone: (405) 235-0040
Fax: (405) 235-4495
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 8498 Oklahoma

Profile Details

NPI number 1881691921
LBN Legal business name Bozalis, John Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated May 22nd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881691921 NPPES
Oklahoma MEDICAID 100133760A

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