Healthcare Provider Details

I. General information

NPI: 1912111238
Provider Name (Legal Business Name): TROY R NORRED MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 ARLINGTON ST
ADA OK
74820-3073
US

IV. Provider business mailing address

3545 NW 58TH ST STE 450
OKLAHOMA CITY OK
73112-4726
US

V. Phone/Fax

Practice location:
  • Phone: 405-948-4040
  • Fax:
Mailing address:
  • Phone: 580-272-0715
  • Fax: 580-272-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number20073
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20073
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number20073
License Number StateOK

VIII. Authorized Official

Name: PAUL SZYMANSKI
Title or Position: CEO
Credential:
Phone: 405-917-3528