Healthcare Provider Details

I. General information

NPI: 1982415733
Provider Name (Legal Business Name): ORTHOPAEDIC AND SPORTS MEDICINE CENTER-NORMAN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5575 N COUNCIL AVE
BLANCHARD OK
73010-8049
US

IV. Provider business mailing address

825 E ROBINSON ST
NORMAN OK
73071-6610
US

V. Phone/Fax

Practice location:
  • Phone: 405-364-7900
  • Fax:
Mailing address:
  • Phone: 405-364-7900
  • Fax: 405-366-6214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EMILY WAINNER
Title or Position: CREDENTIALING
Credential:
Phone: 405-310-6881