Provider Demographics
NPI:1831874759
Name:OKLAHOMA ANESTHESIA SPECIALISTS PLLC
Entity type:Organization
Organization Name:OKLAHOMA ANESTHESIA SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHESIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:GRAHAM
Authorized Official - Last Name:TRENT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:405-226-6806
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-0570
Mailing Address - Country:US
Mailing Address - Phone:800-444-6110
Mailing Address - Fax:
Practice Address - Street 1:25 N ROCKWELL AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6112
Practice Address - Country:US
Practice Address - Phone:405-796-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty