1659456978 NPI number — CITY OF PAWNEE

Table of content: DR. BRADLEY MICHAEL SAUNDERS MD (NPI 1588971436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659456978 NPI number — CITY OF PAWNEE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF PAWNEE
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:
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:
1659456978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 ILLINOIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAWNEE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74058-2036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-538-8278
Provider Business Mailing Address Fax Number:
580-628-2273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 ILLINOIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAWNEE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74058-2036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-538-8278
Provider Business Practice Location Address Fax Number:
580-628-2273
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NOVOTNY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
800-538-8278

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  EMS187 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100819920A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590120213 . This is a "RRMC PROVIDER NUMBER" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




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