Organization · NPI-2

Board Of Regents Of The University Of Oklahoma - Ou Physicians

Nurse Practitioner, Pediatrics · Oklahoma City, OK

NPI number1477833523
StatusActive
Last updated in NPPESAug 22, 2011

Details

NPI
1477833523
Entity type
Organization (NPI-2)
Legal business name
Board Of Regents Of The University Of Oklahoma - Ou Physicians
Organization subpart
No
Enumeration date
Aug 22, 2011
Last updated
Aug 22, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics81001OKYes

Practice location

1200 N Phillips Ave
Suite 9500
Oklahoma City, OK 73104-4600

Phone 405-271-5884 · Fax 405-271-7866

Mailing address

1200 N Phillips Ave
Suite 9500
Oklahoma City, OK 73104-4600

Authorized official

John Grunow
Pediatric Gastroenterology Chair
4052715884

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