NEUROSURGERY CENTER OF SOUTHWEST OKLAHOMA INC (NPI# 1558675785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558675785 |
| Entity Type | Organization |
| Organization Name | NEUROSURGERY CENTER OF SOUTHWEST OKLAHOMA INC |
| Practice Address |
3201 W Gore Blvd Lawton OK 73505-6378 |
| Practice Telephone | 5803536000 |
| Practice Fax Number | 5803530800 |
| Mailing Telephone | 5803536000 |
| Mailing Fax Number | 5803530800 |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2012-06-07 |
| Authorized Official Name | DR. STEPHEN K. OFORI-KWAKYE (PRESIDENT) |
| Authorized Official Telephone | 5803536000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 21457 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | PTAN | OKA103466 | 01 |
| OK | 100000050A | 05 |
| Street Address |
3201 W GORE BLVD |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-6378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144227273 | Prabhudas Khodidas Patel | Surgery | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2005-07-05 |
| 1245744986 | Stephanie Morris | Nurse Practitioner | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2017-11-16 |
| 1114466455 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2017-02-20 |
| 1609315308 | Comanche County Healthcare Corporation | Otolaryngology | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2017-02-15 |
| 1174901102 | Comanche County Healthcare Corportation | Pediatrics | 3201 W Gore Blvd, Suite G1, Lawton, OK 73505-6378 | 2015-05-11 |
| 1780027433 | Amber Lee Cobia | Physical Therapist | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2013-04-12 |
| 1891039517 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 202, Lawton, OK 73505-6378 | 2012-11-19 |
| 1629328786 | Sherif Sayed Ismail Md PC | Skilled Nursing Facility | 3201 W Gore Blvd, Suite 105, Lawton, OK 73505-6378 | 2012-09-17 |
| 1659647501 | Comanche County Healthcare Corp | Family Medicine | 3201 W Gore Blvd, Ste 300, Lawton, OK 73505-6378 | 2012-03-26 |
| 1164736351 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2010-07-30 |
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| 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 |
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| 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 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114560554 | Secure Interpretation, LLC | Neurological Surgery | 5561 South Lewis Ave, Tulsa, OK 74105 | 2019-10-17 |
| 1215356589 | Zoya Alexandrovna Voronovich | Neurological Surgery | 1000 N Lincoln Blvd Ste 300, Oklahoma City, OK 73104-3252 | 2014-04-15 |
| 1588912034 | Carrissa Candler Md Pllc | Neurological Surgery | 120 N Bryant Ave Ste A6, Edmond, OK 73034-6300 | 2012-08-15 |
| 1396034047 | Saints Medical Group, LLC | Neurological Surgery | 800 Nw 9th St Ste 201, Oklahoma City, OK 73106-7253 | 2011-04-04 |
| 1669784351 | Thomas D. Reeder II, D.o., P.C. | Neurological Surgery | 2212 Nw 47th St, Oklahoma City, OK 73112-8848 | 2010-07-09 |
| 1215252440 | Joanna Elizabeth Gernsback | Neurological Surgery | 1000 N Lincoln Blvd # 4000, Oklahoma City, OK 73104-3252 | 2010-03-31 |
| 1811222094 | John Albert Coates | Neurological Surgery | 6416 S Quebec Ave, Tulsa, OK 74136-1611 | 2009-10-06 |
| 1003050493 | Tyler Sean Auschwitz | Neurological Surgery | 2000 South Wheeling, Ste 200, St. Johns Neuroscience Institute, Tulsa, OK 74104 | 2009-04-29 |
| 1881867547 | Rongsheng Cai | Neurological Surgery | 6151 S Yale Ave Ste 2403, Tulsa, OK 74136-1907 | 2008-04-02 |
| 1679759625 | Qualls E Stevens | Neurological Surgery | 1342 S Douglas Blvd, Suite A, Midwest City, OK 73130-5215 | 2008-01-20 |
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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.