1922065382 NPI number — MS. PATRICIA ANN PIGGINS PA

Table of content: MS. PATRICIA ANN PIGGINS PA (NPI 1922065382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922065382 NPI number — MS. PATRICIA ANN PIGGINS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIGGINS
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAGEN
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922065382
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 22063
Provider Second Line Business Mailing Address:
DEPT 0289
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74121-2063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-751-4664
Provider Business Mailing Address Fax Number:
405-749-4561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6585 S YALE AVE
Provider Second Line Business Practice Location Address:
PULMONARY MEDICINE ASSOCIATES, INC SUITE 1200
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-8384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-494-9288
Provider Business Practice Location Address Fax Number:
918-494-9289
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  907 , 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: 100062450A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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