Providence Physician Group Inc

LBN: Providence Physician Group Inc
Providence Physician Group Inc is an health care organization with primary practice located at 300 Rockefeller Dr , Muskogee OK 74401-5075. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Allopathic & Osteopathic Physicians / Anesthesiology is the primary health care specialty. Providence Physician Group Inc can be contacted via phone (918) 684-2557, or through Blair, Jim via phone (918) 684-2557.

Contact Information

Primary practice address
300 Rockefeller Dr Muskogee OK 74401-5075
Phone: (918) 684-2557
Fax: (405) 948-6507
Website:
Map and Directions
Authorized official contact:
Name: Blair, Jim
Phone: (918) 684-2557

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X

Profile Details

NPI number 1861436636
LBN Legal business name Providence Physician Group Inc
DBA Doing business as
Authorized official Blair, Jim
Entity Organization
Organization subpart 1 No
Enumeration date Jun 15th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861436636 NPPES
Oklahoma Other DA6664 RAILROAD MEDICARE
Oklahoma Other 3159009 RAILROAD MEDICARE

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