Provider Demographics
NPI:1780906594
Name:AM PM DOCTORS OCCUPATIONAL PAIN CENTER
Entity type:Organization
Organization Name:AM PM DOCTORS OCCUPATIONAL PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-722-5500
Mailing Address - Street 1:15000 N DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:JONES
Mailing Address - State:OK
Mailing Address - Zip Code:73049-3447
Mailing Address - Country:US
Mailing Address - Phone:405-248-8003
Mailing Address - Fax:405-720-4404
Practice Address - Street 1:7109 W HEFNER RD
Practice Address - Street 2:SUITE D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4535
Practice Address - Country:US
Practice Address - Phone:405-248-8003
Practice Address - Fax:405-720-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15874208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty