Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Physician Group Inc

Organization Anesthesiology Physician · NPI 1861436636

Providence Physician Group Inc is an Anesthesiology Physician in Muskogee, Oklahoma. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone: (918) 684-2557
Fax: (405) 948-6507
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X
Anesthesiology Physician Taxonomy 207L00000X

Record details

NPI number1861436636
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jim Blair — Ceo · (918) 684-2557
NPI enumeratedJune 15, 2006
Last updated in NPPESSeptember 11, 2025
Mailing addressPo Box 1664, Muskogee, OK 74402-1664

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