Provider Demographics
NPI:1194562991
Name:ORTHOPAEDIC CENTER, PC
Entity type:Organization
Organization Name:ORTHOPAEDIC CENTER, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HENDRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-925-3248
Mailing Address - Street 1:512 N FRANKLIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-2490
Mailing Address - Country:US
Mailing Address - Phone:918-582-6800
Mailing Address - Fax:918-925-3248
Practice Address - Street 1:512 N FRANKLIN ST STE 200
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2490
Practice Address - Country:US
Practice Address - Phone:918-582-6800
Practice Address - Fax:918-925-3248
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC CENTER, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-10
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty