Provider Demographics
NPI:1881287845
Name:ORTHOPEDIC AND TRAUMA INSTITUTE LLC
Entity type:Organization
Organization Name:ORTHOPEDIC AND TRAUMA INSTITUTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:H
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:405-252-7484
Mailing Address - Street 1:PO BOX 258881 SECTION 681
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73125-8881
Mailing Address - Country:US
Mailing Address - Phone:405-252-7484
Mailing Address - Fax:405-252-7490
Practice Address - Street 1:3705 NW 63RD ST STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1937
Practice Address - Country:US
Practice Address - Phone:405-252-7484
Practice Address - Fax:405-252-7490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty