Southwest Pathology Associates LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

SOUTHWEST PATHOLOGY ASSOCIATES LLC

Practice address

8803 S 101St E Ave
Tulsa, OK 74133

Phone

(918) 582-0001

Fax

(917) 582-0003

NPI assigned

Jun 27, 2008

Last updated

Jun 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Melvin J. Van Boven, D.O.NPI 1003910522

Title

President

Phone

(918) 582-0001

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Melvin J Vanboven, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Tulsa, OK
  • NPI 1003910522
  Authorized official Same address or phone
• Anthony Alfrey, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Tulsa, OK
  • NPI 1245334887
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1902068265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26303",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260303",
            "telephone_number": "918-582-0001",
            "fax_number": "917-582-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 S 101ST E AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74133",
            "telephone_number": "918-582-0001",
            "fax_number": "917-582-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PATHOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "VAN BOVEN",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-582-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southside Dermatology PLLC
• Southwest Neurology Specialist LLC
• Southwest Pathology, Inc
• Southwest Therapry Consultants
• Southwestern Regional Hospital
• Southwestern Regional Medical Center, LLC
• Stephanie P Souvannachak-Cowick, OD

• Anatomic Pathology & Clinical Pathology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Anatomic Pathology & Clinical Pathology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.