Provider Demographics
NPI:1265533509
Name:ORTHOPEDIC PRODUCTS & SERVICES
Entity type:Organization
Organization Name:ORTHOPEDIC PRODUCTS & SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-842-2500
Mailing Address - Street 1:PO BOX 270724
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73137-0724
Mailing Address - Country:US
Mailing Address - Phone:405-842-2500
Mailing Address - Fax:405-842-2509
Practice Address - Street 1:214 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4221
Practice Address - Country:US
Practice Address - Phone:405-842-2500
Practice Address - Fax:405-842-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS456342OtherBCBS KS
OK731499673001OtherBCBS OK
OK1268670001Medicare NSC