Provider Demographics
NPI:1306030564
Name:MIDWEST PULMONARY AND SLEEP
Entity Type:Organization
Organization Name:MIDWEST PULMONARY AND SLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-232-5555
Mailing Address - Street 1:PO BOX 2118
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-2118
Mailing Address - Country:US
Mailing Address - Phone:405-232-5555
Mailing Address - Fax:405-270-0551
Practice Address - Street 1:608 NW 9TH SUITE 2100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1049
Practice Address - Country:US
Practice Address - Phone:405-232-5555
Practice Address - Fax:405-270-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty