Provider Demographics
NPI:1124317771
Name:ADVANCED PATHOLOGY, PC
Entity type:Organization
Organization Name:ADVANCED PATHOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-536-7400
Mailing Address - Street 1:PO BOX 25016
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73125-0016
Mailing Address - Country:US
Mailing Address - Phone:580-536-7400
Mailing Address - Fax:580-536-7402
Practice Address - Street 1:5405 DAUN
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8508
Practice Address - Country:US
Practice Address - Phone:580-536-7400
Practice Address - Fax:580-536-7402
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOY A. SNELL MD, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory