Provider Demographics
NPI:1043854300
Name:PAHL PHARMACEUTICAL PROFESSIONALS
Entity Type:Organization
Organization Name:PAHL PHARMACEUTICAL PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-525-2222
Mailing Address - Street 1:3535 NW 58TH ST STE 850E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4804
Mailing Address - Country:US
Mailing Address - Phone:405-525-2222
Mailing Address - Fax:405-525-9800
Practice Address - Street 1:3535 NW 58TH ST STE 850E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4804
Practice Address - Country:US
Practice Address - Phone:405-525-2222
Practice Address - Fax:405-525-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch