Healthcare Provider Details

I. General information

NPI: 1487671285
Provider Name (Legal Business Name): FAMILY MEDICINE ASSOCIATES OF NORMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 ALAMEDA ST
NORMAN OK
73071-3006
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-4511
  • Fax: 405-360-6331
Mailing address:
  • Phone: 405-321-4511
  • Fax: 405-360-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG L TERRELL
Title or Position: SR VP, COO
Credential:
Phone: 405-307-1000