| Organization Name: | PAIN INSTITUTE OF TULSA, INC |
| NPI Number: | 1124139126 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND F SORENSEN (OWNER) |
| Mailing Address: | 1145 S Utica Ave Suite 364 Tulsa |
| State: | OK US |
| Postal Code: | 741044004 |
| Phone Number: | 9184965195 |
| Fax Number: | 9184965194 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 06/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 1434 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |