Provider Demographics
NPI:1326117888
Name:OKLAHOMA REHAB SERVICES, INC.
Entity Type:Organization
Organization Name:OKLAHOMA REHAB SERVICES, INC.
Other - Org Name:OKLAHOMA REHAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:N
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-488-9992
Mailing Address - Street 1:4833 S SHERIDAN RD
Mailing Address - Street 2:SUITE 414
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5750
Mailing Address - Country:US
Mailing Address - Phone:918-488-9992
Mailing Address - Fax:918-488-9993
Practice Address - Street 1:4833 S SHERIDAN RD
Practice Address - Street 2:SUITE 414
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5750
Practice Address - Country:US
Practice Address - Phone:918-488-9992
Practice Address - Fax:918-488-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK1843261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK000374507001OtherBCBS
OK100748900CMedicaid
OK611954700OtherUS DEPT OF LABOR
OK700522047OtherMEDICARE PART B
OK731596739OtherTRICARE
OK374507Medicare ID - Type Unspecified
OK000374507001OtherBCBS