SOUTHWESTERN NEUROSURGERY PHYSICIANS LLC (NPI# 1477595924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477595924 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN NEUROSURGERY PHYSICIANS LLC |
| Other Organization Name | SOUTHWESTERN NEUROSCIENCES |
| Practice Address |
5604 Sw Lee Blvd Suite 357 Lawton OK 73505-9681 |
| Practice Telephone | 5805314600 |
| Practice Fax Number | 5805316405 |
| Mailing Telephone | 5805314600 |
| Mailing Fax Number | 5805316405 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2008-08-23 |
| Authorized Official Name | MR. JON O'SHAUGHNESSY (CEO) |
| Authorized Official Telephone | 5805314600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
26013 | OK | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 25895 | OK | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 25956 | OK | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | 23774 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200051010A | 05 | |
| OK | 200035200A | 05 | |
| OK | 200199360A | 05 |
| Other Name | Type Code |
|---|---|
| Southwestern Neurosciences | Doing Business As Name - Organization |
| Street Address |
5604 SW LEE BLVD SUITE 357 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-9681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689669905 | David M Pagnanelli | Neurological Surgery | 5604 Sw Lee Blvd, Suite 357, Lawton, OK 73505-9681 | 2005-09-13 |
| 1952582900 | Lawton Family Practice & Allergy Clinic | Family Medicine | 5604 Sw Lee Blvd, Suite 245, Lawton, OK 73505-9681 | 2007-11-19 |
| 1558588616 | Erlan Duus M.d. Pllc | Surgery | 5604 Sw Lee Blvd, Ste 310, Lawton, OK 73505-9681 | 2007-04-19 |
| 1669481438 | Erlan C Duus | Plastic Surgery | 5604 Sw Lee Blvd, Suite 310, Lawton, OK 73505-9681 | 2006-08-07 |
| 1215952023 | The Breast Center | Clinic/Center | 5604 Sw Lee Blvd, Suite 150, Lawton, OK 73505-9681 | 2006-07-13 |
| 1700853801 | Behrooz Tohidi | Orthopaedic Surgery | 5604 Sw Lee Blvd, Suite 210, Lawton, OK 73505-9663 | 2006-03-07 |
| 1992778831 | Chukwukadibia J Odunukwe | Surgery | 5604 Sw Lee Blvd, Suite 210, Lawton, OK 73505-9681 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710540257 | David M Mckalip Md Pllc | Neurological Surgery | 5108 W Gore Blvd Ste 2b, Lawton, OK 73505-6025 | 2019-04-19 |
| 1336257641 | Luis Reina Md | Neurological Surgery | 2701 Sw A Ave, Lawton, OK 73505-7123 | 2006-08-27 |
| 1821106139 | Desiree Ortiz-cruz, Md, PC | Neurological Surgery | 2701 Sw A Avenue, Lawton, OK 73506 | 2006-08-27 |
| 1689669905 | David M Pagnanelli | Neurological Surgery | 5604 Sw Lee Blvd, Suite 357, Lawton, OK 73505-9681 | 2005-09-13 |
| 1558675785 | Neurosurgery Center of Southwest Oklahoma Inc | Neurological Surgery | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2010-07-29 |
| 1083634943 | Comanche County Healthcare | Neurological Surgery | 110 Nw 31st St, 2nd Floor, Lawton, OK 73505 | 2006-07-20 |
| 1770500753 | Comanche County Healthcare | Neurological Surgery | 4417 W Gore Blvd, Suite 9, Lawton, OK 73505 | 2006-07-16 |
| 1013975580 | Stephen Kwame Ofori-kwakye | Neurological Surgery | 3201 W Gore Blvd, Suite 303, Lawton, OK 73505-6378 | 2006-05-03 |
| 1790771095 | Johnny D Duncan | Neurological Surgery | 4417 W Gore Blvd, Suite 9, Lawton, OK 73505 | 2005-09-22 |
| 1538155122 | Mark O Duncan | Neurological Surgery | 110 Nw 31st St Fl 2, Lawton, OK 73505-6100 | 2005-09-20 |
| Find all providers in LAWTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.