Provider Demographics
NPI:1750360061
Name:EMERGENCY MANAGEMENT ASSOCIATES PC
Entity type:Organization
Organization Name:EMERGENCY MANAGEMENT ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-307-6950
Mailing Address - Street 1:PO BOX 25277
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-5277
Mailing Address - Country:US
Mailing Address - Phone:918-307-6920
Mailing Address - Fax:918-307-6951
Practice Address - Street 1:10501 E 91ST ST
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5790
Practice Address - Country:US
Practice Address - Phone:918-307-6920
Practice Address - Fax:918-307-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100745790AMedicaid
OK=========Medicare PIN