Provider Demographics
NPI:1932405313
Name:PEDIATRIC RESPIRATORY SLEEP SERVICES
Entity Type:Organization
Organization Name:PEDIATRIC RESPIRATORY SLEEP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:POPEJOY
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:918-852-3497
Mailing Address - Street 1:2424 E 21ST ST
Mailing Address - Street 2:440
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1711
Mailing Address - Country:US
Mailing Address - Phone:918-394-3497
Mailing Address - Fax:918-392-0597
Practice Address - Street 1:2424 E 21ST ST
Practice Address - Street 2:440
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1711
Practice Address - Country:US
Practice Address - Phone:918-394-3497
Practice Address - Fax:918-392-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK149252080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty