Provider Demographics
NPI:1295760791
Name:PULMONARY MEDICINE ASSOCIATES INC
Entity type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHELBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-494-9288
Mailing Address - Street 1:PO BOX 3478
Mailing Address - Street 2:DEPARTMENT A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74101-3478
Mailing Address - Country:US
Mailing Address - Phone:918-494-9288
Mailing Address - Fax:918-494-9289
Practice Address - Street 1:6485 S YALE AVE
Practice Address - Street 2:1200
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-494-9288
Practice Address - Fax:918-494-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200109130AMedicaid
OKCO5020Medicare PIN
OK=========Medicare PIN