Provider Demographics
NPI:1467541854
Name:NORTHWEST OKLAHOMA CARDIOVASCULAR CONSULTANTS PC
Entity Type:Organization
Organization Name:NORTHWEST OKLAHOMA CARDIOVASCULAR CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BARTOLOZZI
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:580-242-5800
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-0946
Mailing Address - Country:US
Mailing Address - Phone:580-242-5800
Mailing Address - Fax:580-242-5881
Practice Address - Street 1:2411 HERITAGE TRL STE 10
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1652
Practice Address - Country:US
Practice Address - Phone:580-242-5800
Practice Address - Fax:580-242-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21462207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDA4205OtherRAILROAD MEDICARE
OK200021920AMedicaid
OK200021920AMedicaid