Provider Demographics
NPI:1518132018
Name:ALLIED PHYSICIAN'S GROUP INC PC
Entity Type:Organization
Organization Name:ALLIED PHYSICIAN'S GROUP INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-495-5154
Mailing Address - Street 1:13316 S WESTERN AVE
Mailing Address - Street 2:SUITE M
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7302
Mailing Address - Country:US
Mailing Address - Phone:405-495-5154
Mailing Address - Fax:405-603-2313
Practice Address - Street 1:13316 S WESTERN AVE
Practice Address - Street 2:SUITE M
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7302
Practice Address - Country:US
Practice Address - Phone:405-495-5154
Practice Address - Fax:405-603-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK600522049207Q00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK600522049OtherPROVIDER