1205887916 NPI number — HCA HEALTH SERVICES OF OKLAHOMA, INC.

Table of content: MR. BRIAN DAVID ZELICKSON M.D. (NPI 1336195148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205887916 NPI number — HCA HEALTH SERVICES OF OKLAHOMA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCA HEALTH SERVICES OF OKLAHOMA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205887916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 S BRYANT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73034-6309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-341-6100
Provider Business Mailing Address Fax Number:
405-359-5500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 S BRYANT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73034-6309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-341-6100
Provider Business Practice Location Address Fax Number:
405-359-5500
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CAREY
Authorized Official First Name:
LAVAUGHN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
405-359-5530

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100697940A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 370148001 . This is a "BLUE CROSS" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 62175765500 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04338300 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80632600 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 072687901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1703222 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01836736 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0376267 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0572768 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 621757655001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 016104507 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200003680A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 621757655 . This is a "TRICARE- ACUTE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 941262 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 149055105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 166280900 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 75473267 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: EDM0148N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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