Bozalis, John Russell
Bozalis, John Russell is an individual health care provider with primary practice located at 750 Ne 13Th St , Oklahoma City OK 73104-5051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Bozalis, John Russell can be contacted via phone (405) 235-0040.Contact Information
Primary practice address
750 Ne 13Th St
Oklahoma City OK 73104-5051
Phone: (405) 235-0040
Fax: (405) 235-4495
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 8498 | Oklahoma |
Profile Details
| NPI number | 1881691921 |
|---|---|
| LBN Legal business name | Bozalis, John Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | May 22nd, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881691921 | NPPES |
| Oklahoma | MEDICAID | 100133760A |
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