| Oklahoma Neuropsychiatric Institute | |
|
1129 S Aspen Ave Broken Arrow OK 74012-4859 | |
| (918) 764-9300 | |
| Not Available |
| Full Name | Oklahoma Neuropsychiatric Institute |
|---|---|
| Speciality | Clinic/Center |
| Location | 1129 S Aspen Ave, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Edward Gerard Melton (PRESIDENT) |
| Authorized Official Contact | 9187649300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma Neuropsychiatric Institute Po Box 35264 Tulsa OK 74153-0264 Ph: (918) 764-9300 | Oklahoma Neuropsychiatric Institute 1129 S Aspen Ave Broken Arrow OK 74012-4859 Ph: (918) 764-9300 |
| NPI Number | 1134300049 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 03/07/2016 |
| Medicare PECOS PAC ID | 5597844183 |
|---|---|
| Medicare Enrollment ID | O20080507000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134300049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 24098 (Oklahoma) | Primary |
| Provider Name | Tanith E Garner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386956217 PECOS PAC ID: 8224215868 Enrollment ID: I20110607000566 |
| Provider Name | Lindsay M Bible |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841442951 PECOS PAC ID: 7618292897 Enrollment ID: I20150210001652 |
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