Provider Demographics
NPI:1720620610
Name:OKLAHOMA OASIS HYPERBARICS LLC
Entity Type:Organization
Organization Name:OKLAHOMA OASIS HYPERBARICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:CONRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-808-7737
Mailing Address - Street 1:120 N BRYANT AVE STE A4
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 N BRYANT AVE STE A4
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6300
Practice Address - Country:US
Practice Address - Phone:405-808-7737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty