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Contact Information

EAGLE SPORTS MEDICINE
2501 E MEMORIAL RD
EDMOND, OK73013-5525
 Phone: 405-425-1960
 Fax: 405-425-1962
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for EAGLE SPORTS MEDICINE

NPI Number 1942624135
LBN Legal business name EAGLE SPORTS MEDICINE
Authorized official MICHELLE KRAUSE - (REHABILITATION COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/10/2014
Last updated 10/26/2016 - About 10 years ago
Identifiers
OK License # 2813
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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