Provider Demographics
| NPI: | 1669559720 |
|---|---|
| Name: | SOUTHWEST ORTHOPAEDIC SPECIALISTS, P.L.L.C. |
| Entity type: | Organization |
| Organization Name: | SOUTHWEST ORTHOPAEDIC SPECIALISTS, P.L.L.C. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JOE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | STREICH |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 405-619-4410 |
| Mailing Address - Street 1: | 8100 S WALKER AVE BLDG A |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OKLAHOMA CITY |
| Mailing Address - State: | OK |
| Mailing Address - Zip Code: | 73139-9475 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 405-632-4468 |
| Mailing Address - Fax: | 405-631-4964 |
| Practice Address - Street 1: | 8100 S WALKER AVE BLDG A |
| Practice Address - Street 2: | |
| Practice Address - City: | OKLAHOMA CITY |
| Practice Address - State: | OK |
| Practice Address - Zip Code: | 73139-9475 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 405-632-4468 |
| Practice Address - Fax: | 405-632-0436 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-11-01 |
| Last Update Date: | 2024-12-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | Group - Multi-Specialty |
| No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
| No | 207XP3100X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Pediatric Orthopaedic Surgery | Group - Multi-Specialty |
| No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
| No | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | Group - Multi-Specialty |
| No | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | Group - Multi-Specialty |
| No | 207XX0801X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma | Group - Multi-Specialty |
| No | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Multi-Specialty | |
| No | 2082S0105X | Allopathic & Osteopathic Physicians | Plastic Surgery | Surgery of the Hand | Group - Multi-Specialty |
| No | 2086S0105X | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand | Group - Multi-Specialty |
| No | 2086S0122X | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery | Group - Multi-Specialty |
| No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | Group - Multi-Specialty | |
| No | 2082S0099X | Allopathic & Osteopathic Physicians | Plastic Surgery | Plastic Surgery Within the Head and Neck | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| OK | 100745060A | Medicaid | |
| 0440400001 | Medicare NSC |