| Board Of Regents Of The University Of Oklahoma - Ou Phsycians Variety | |
|
420 Nw 6th St Oklahoma City OK 73102-2805 | |
| (405) 235-6466 | |
| Not Available |
| Full Name | Board Of Regents Of The University Of Oklahoma - Ou Phsycians Variety |
|---|---|
| Speciality | Clinic/center |
| Location | 420 Nw 6th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Brian Maddy (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4052711515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Regents Of The University Of Oklahoma - Ou Phsycians Variety 1122 Ne 13th St Ori 236 Oklahoma City OK 73117-1039 Ph: () - | Board Of Regents Of The University Of Oklahoma - Ou Phsycians Variety 420 Nw 6th St Oklahoma City OK 73102-2805 Ph: (405) 235-6466 |
| NPI Number | 1497972988 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 09/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497972988 | NPI | - | NPPES |
| 100744720R | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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