Provider Demographics
NPI:1538224944
Name:ELK CITY SURGICAL CENTER
Entity type:Organization
Organization Name:ELK CITY SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-225-4699
Mailing Address - Street 1:1800 W 1ST ST
Mailing Address - Street 2:SUITE 3, P O BOX 40
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-3133
Mailing Address - Country:US
Mailing Address - Phone:580-225-4699
Mailing Address - Fax:580-243-6823
Practice Address - Street 1:1800 W 1ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-3133
Practice Address - Country:US
Practice Address - Phone:580-225-4699
Practice Address - Fax:580-243-6823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24293174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty