Organization Name: | SOKOLOSKY CLINIC P.C. |
NPI Number: | 1205040516 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWARD J SOKOLOSKY (OWNER) |
Mailing Address: | 1102 N Main St Owasso |
State: | OK US |
Postal Code: | 740555571 |
Phone Number: | 9182725355 |
Fax Number: | 9182721475 |
NPI Enumeration Date: | 05/09/2007 |
NPI Last Update Date: | 12/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 1402 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |