Provider Demographics
NPI:1326184094
Name:RESPIRATORY SPECIALTIES
Entity Type:Organization
Organization Name:RESPIRATORY SPECIALTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:918-787-6393
Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74067-1045
Mailing Address - Country:US
Mailing Address - Phone:918-787-6393
Mailing Address - Fax:918-787-5778
Practice Address - Street 1:63193 E 291 RD
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7905
Practice Address - Country:US
Practice Address - Phone:918-787-6393
Practice Address - Fax:918-787-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45-S-1007332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1257250001Medicare ID - Type Unspecified