Provider Demographics
NPI:1407044092
Name:AUSCHWITZ, TED S III (DO)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:S
Last Name:AUSCHWITZ
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:226 SE DEBELL
Mailing Address - Street 2:BLDG A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006
Mailing Address - Country:US
Mailing Address - Phone:918-331-1045
Mailing Address - Fax:918-331-1051
Practice Address - Street 1:224 SE DEBELL
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006
Practice Address - Country:US
Practice Address - Phone:918-331-1045
Practice Address - Fax:918-331-1051
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4850208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4850OtherOK STATE LICENSE NUMBER
MI5101016322OtherMICHIGAN LISCENSE NUMBER