Provider Demographics
NPI:1598190845
Name:ADVANCED INVASIVE PAIN MANAGEMENT OF TULSA, PLLC
Entity Type:Organization
Organization Name:ADVANCED INVASIVE PAIN MANAGEMENT OF TULSA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-943-7246
Mailing Address - Street 1:5018 E 68TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3367
Mailing Address - Country:US
Mailing Address - Phone:918-925-9905
Mailing Address - Fax:918-708-1362
Practice Address - Street 1:5018 E 68TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3367
Practice Address - Country:US
Practice Address - Phone:918-925-9905
Practice Address - Fax:918-708-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty