Doctor Name: | ERIC W MIX |
NPI Number: | 1003806704 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 4316 |
Business Practice Address: | 300 Rockefeller Dr Muskogee, OK - 744015075 |
Business Phone Number: | 9187819466 |
Business Fax Number: | |
Mailing Address: | Lockbox #17, 2424 E. 21st #100 TULSA |
State: | OK |
Postal Code: | 741141711 |
Phone Number: | 8663218433 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2005 |
NPI Last Update Date: | 08/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | 4316 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |