Provider Demographics
NPI:1508967811
Name:ALM PLLC
Entity Type:Organization
Organization Name:ALM PLLC
Other - Org Name:TULSA BRAIN AND SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:TERRELL
Authorized Official - Last Name:MAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-764-9999
Mailing Address - Street 1:7702 E 91ST ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6054
Mailing Address - Country:US
Mailing Address - Phone:918-764-9999
Mailing Address - Fax:918-764-9222
Practice Address - Street 1:7702 E 91ST ST
Practice Address - Street 2:SUITE 220
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6054
Practice Address - Country:US
Practice Address - Phone:918-764-9999
Practice Address - Fax:918-764-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4163207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKI07803Medicare UPIN
OK300522253Medicare PIN