Provider Demographics
NPI:1225349855
Name:PM MEDICAL, PC
Entity Type:Organization
Organization Name:PM MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SISK
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:405-802-2419
Mailing Address - Street 1:1508 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4328
Mailing Address - Country:US
Mailing Address - Phone:405-285-7657
Mailing Address - Fax:
Practice Address - Street 1:1508 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-4328
Practice Address - Country:US
Practice Address - Phone:405-285-7657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty