Provider Demographics
NPI:1285751263
Name:OB GYN ASSOCIATES LLC
Entity type:Organization
Organization Name:OB GYN ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-606-7425
Mailing Address - Street 1:1140 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3602
Mailing Address - Country:US
Mailing Address - Phone:405-632-1730
Mailing Address - Fax:405-632-2640
Practice Address - Street 1:1140 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3602
Practice Address - Country:US
Practice Address - Phone:405-632-1730
Practice Address - Fax:405-632-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty