Sooner Pain Clinic, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

18162 Issued in OK

Legal business name

SOONER PAIN CLINIC, LLC

Practice address

5509 Main St
Suite 100
Del City, OK 73115-5510

Phone

(405) 604-0901

Fax

(405) 604-0902

NPI assigned

Oct 15, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

George B Dawson, M.D.

Title

Owner

Phone

(405) 604-0901

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1164893228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270663",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731370663",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 MAIN ST",
            "address_2": "SUITE 100",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731155510",
            "telephone_number": "405-604-0901",
            "fax_number": "405-604-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOONER PAIN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-604-0901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "18162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Truely Smith
• Ricky Smith
• Zach Alan Smith
• Kimberly Sogunro
• Nikke Sogunro
• Aleicia L Stafford
• Carrol Lea Stanley III, FOSTER MOTHER
• Shallette R. Starnes
• Antoinette Latrice Starr
• Shawna Pauline Stephens

• Interventional Pain Medicine Physician in Del City, OK
• Providers in Del City, OK by specialty
• Interventional Pain Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.