Provider Demographics
NPI:1811022593
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:OFFICE MANAGER
Authorized Official - Prefix:MRS
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 1:6820 NW 23RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5217
Mailing Address - Country:US
Mailing Address - Phone:405-495-5154
Mailing Address - Fax:
Practice Address - Street 1:1200 S AIR DEPOT BLVD
Practice Address - Street 2:STE P
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4866
Practice Address - Country:US
Practice Address - Phone:405-495-5154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK600522049OtherPROVIDER