Provider Demographics
NPI:1871303503
Name:APEX PAIN MANAGEMENT
Entity type:Organization
Organization Name:APEX PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN RELATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSQUITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-519-4090
Mailing Address - Street 1:1030 E WASHINGTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4850
Mailing Address - Country:US
Mailing Address - Phone:918-401-1002
Mailing Address - Fax:918-493-3304
Practice Address - Street 1:1030 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4850
Practice Address - Country:US
Practice Address - Phone:918-401-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty