NPIMap

Organization Active NPI

Surgical Specialists of Oklahoma PLLC

  • Surgery Physician
  • Midwest City, OK
National Provider Identifier
1871542639
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL SPECIALISTS OF OKLAHOMA PLLC
Practice address
230 N Midwest Blvd
Midwest City, OK 73110-4321
Phone
(405) 737-8455
NPI assigned
May 9, 2006
Last updated
Aug 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Philip Malone
Title
Practice Director
Phone
(405) 737-8455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

230 N Midwest Blvd
Midwest City, OK 73110-4321

Mailing address

230 N Midwest Blvd
Midwest City, OK 73110-4321
Phone (405) 737-8455

Other identifiers 2

IdentifierTypeStateIssuer
100747340AMedicaidOK
121446OtherPAMEDICARE GROUP HIGHMARK

National Provider Directory

National Provider Directory

Locations

230 N Midwest Blvd
Oklahoma City, OK 73110
Phone (405) 737-8455

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1871542639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MIDWEST BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104321",
            "telephone_number": "405-737-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N MIDWEST BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104321",
            "telephone_number": "405-737-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS OF OKLAHOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "405-737-8455"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100747340A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP HIGHMARK",
            "identifier": "121446",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.