Provider Demographics
NPI:1750539680
Name:PAHL & ASSOCIATES, PC
Entity type:Organization
Organization Name:PAHL & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORG
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-525-2222
Mailing Address - Street 1:2301 W. I - 44 SERVICE RD,
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8729
Mailing Address - Country:US
Mailing Address - Phone:405-525-2222
Mailing Address - Fax:405-525-9300
Practice Address - Street 1:2301 W I 44 SERVICE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8729
Practice Address - Country:US
Practice Address - Phone:405-525-2222
Practice Address - Fax:405-525-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17260261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health