Board Of Regents Of The Univ Of Oklahoma-Ou Phys Edmond Clinic
Clinic/Center in Edmond, OK. Organization (NPI-2).
NPI number1740383603
StatusActive
Last updated in NPPESOct 5, 2009
Details
- NPI
- 1740383603
- Entity type
- Organization (NPI-2)
- Legal business name
- Board Of Regents Of The Univ Of Oklahoma-Ou Phys Edmond Clinic
- Organization subpart
- No
- Enumeration date
- Sep 6, 2006
- Last updated
- Oct 5, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Ou Physicians Edmond Clinic (Other Name)
Practice location
105 N BryantSuite 305
Edmond, OK 73034
Phone 405-330-8641
Mailing address
1122 Ne 13th StOri236
Oklahoma City, OK 73117-1039
Phone 405-271-1515
Authorized official
Brian Maddy
Chief Executive Officer
4052711515
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