Provider Demographics
NPI:1114265576
Name:NATIONAL PRACTITIONERS SERVICES LLC
Entity Type:Organization
Organization Name:NATIONAL PRACTITIONERS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-640-0277
Mailing Address - Street 1:5515 E 76TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8429
Mailing Address - Country:US
Mailing Address - Phone:918-640-0277
Mailing Address - Fax:918-747-4920
Practice Address - Street 1:5515 E 76TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8429
Practice Address - Country:US
Practice Address - Phone:918-640-0277
Practice Address - Fax:918-747-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service