Provider Demographics
NPI:1598029431
Name:CLINICAL MEDICAL CONSULTANTS OF OKLAHOMA LLC
Entity Type:Organization
Organization Name:CLINICAL MEDICAL CONSULTANTS OF OKLAHOMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:POHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-407-4608
Mailing Address - Street 1:10807 S 91ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7077
Mailing Address - Country:US
Mailing Address - Phone:918-407-4608
Mailing Address - Fax:
Practice Address - Street 1:10807 S 91ST EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7077
Practice Address - Country:US
Practice Address - Phone:918-407-4608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty