Dustin Shaun Tedesco Pllc

LBN: Dustin Shaun Tedesco Pllc
Dustin Shaun Tedesco Pllc is an health care organization with primary practice located at 1553 N Porter Ave , Norman OK 73071-6621. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as the primary health care specialty. Dustin Shaun Tedesco Pllc can be contacted via phone (405) 217-8500, or through Tedesco, Shaun via phone (405) 936-0504.

Contact Information

Primary practice address
1553 N Porter Ave Norman OK 73071-6621
Phone: (405) 217-8500
Fax: (405) 217-8501
Website:
Map and Directions
Authorized official contact:
Name: Tedesco, Shaun Doctor of Medicine (MD)
Phone: (405) 936-0504

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 25729 Oklahoma

Profile Details

NPI number 1063822633
LBN Legal business name Dustin Shaun Tedesco Pllc
DBA Doing business as
Authorized official Tedesco, Shaun Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2014
Last updated May 5th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063822633 NPPES
Oklahoma MEDICAID 200206650B

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