Provider Demographics
NPI:1609465269
Name:OKLAHOMA SPINE SURGERY CENTER
Entity Type:Organization
Organization Name:OKLAHOMA SPINE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-921-6562
Mailing Address - Street 1:13313 N MERIDIAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8316
Mailing Address - Country:US
Mailing Address - Phone:405-849-6979
Mailing Address - Fax:405-849-9264
Practice Address - Street 1:13313 N MERIDIAN AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8316
Practice Address - Country:US
Practice Address - Phone:405-849-6979
Practice Address - Fax:405-849-9264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical