Provider Demographics
NPI:1962493437
Name:OKLAHOMA CARDIOVASCULAR ASSOCIATES.PC
Entity Type:Organization
Organization Name:OKLAHOMA CARDIOVASCULAR ASSOCIATES.PC
Other - Org Name:CARDIAC AIR TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAKULAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-608-3800
Mailing Address - Street 1:4050 WEST MEMORIAL RD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-608-3800
Mailing Address - Fax:405-608-3838
Practice Address - Street 1:4050 WEST MEMORIAL RD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-608-3800
Practice Address - Fax:405-608-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport