Blue Bayou Inc

NPI 1043568538 - Family Medicine - 207QA0000X

NPI Details
NPI 1043568538
Enumeration Date 08/15/2012
Last Updated 09/18/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name JAMES JAMES
Position CEO
Phone (405) 229-3410
Fax
Practice Location
100 PARK AVE
OKLAHOMA CITY OK, 73102-8006, US
Phone (405) 229-3410
Fax
Business Location
100 PARK AVE
OKLAHOMA CITY OK, 73102-8006, US
Phone (405) 229-3410
Fax
Toxanomy
Taxonomy Code 207QA0000X
License State Oklahoma
License Number 12345
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According to our database, Blue Bayou Inc NPI is 1043568538, taxonomy code is 207QA0000X and license number is 12345, license state is located at Oklahoma. Blue Bayou Inc physically located at 100 Park Ave, Oklahoma City OK, 73102-8006. NPI Number 1033115704 has the healthcare provider type.

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1043568538 NPI number is provided on an as is basis without warranty of any kind. 1043568538 is maintained by the National Plan & Provider Enumeration System. The contents of Blue Bayou Inc are for informational purposes only.