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

Broken Arrow Pain Specialist, LLC

Organization Pain Medicine Physician · NPI 1104549427

Broken Arrow Pain Specialist, LLC provides Pain Medicine Physician services in Tahlequah, Oklahoma. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2028 Mahaney Ave
Tahlequah, OK 74464-5783
Phone: (918) 992-6050
Fax: (833) 763-2349
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X

Record details

NPI number1104549427
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ian Kelley — Sole Member · (918) 633-0447
Other names Oklahoma Pain Specialist
NPI enumeratedSeptember 21, 2022
Last updated in NPPESJuly 22, 2026
Certification dateJuly 22, 2026
Mailing address2028 Mahaney Ave, Tahlequah, OK 74464-5783

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