Provider Demographics
NPI:1376044503
Name:PMO MEDICAL PLLC
Entity Type:Organization
Organization Name:PMO MEDICAL PLLC
Other - Org Name:PAIN MANAGEMENT OF OKLAHOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-794-6008
Mailing Address - Street 1:701 W QUEENS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1785
Mailing Address - Country:US
Mailing Address - Phone:405-794-6008
Mailing Address - Fax:918-516-3447
Practice Address - Street 1:601 E 13TH ST STE H
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-2962
Practice Address - Country:US
Practice Address - Phone:918-786-2243
Practice Address - Fax:918-516-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty