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Medical Center Pain Clinic, PLLC

Clinic/Center, Pain in Oklahoma City, OK. Organization (NPI-2).

NPI number1477829554
StatusActive
Last updated in NPPESJul 14, 2018

Details

NPI
1477829554
Entity type
Organization (NPI-2)
Legal business name
Medical Center Pain Clinic, PLLC
Organization subpart
No
Enumeration date
Mar 22, 2012
Last updated
Jul 14, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP3300X Clinic/Center, Pain15874OKYes

Practice location

1226 N Shartel Ave
Suite 300
Oklahoma City, OK 73103

Phone 405-232-8003 · Fax 405-232-8808

Mailing address

2700 Ne 63rd St
Oklahoma City, OK 73111-8305

Phone 405-271-5859 · Fax 405-232-8808

Authorized official

David Paul Ellis
Registered Agent
4052328003

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