Healthcare Provider Details

I. General information

NPI: 1497035117
Provider Name (Legal Business Name): NRHS WEST FAMILY MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 12/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD SUITE 104
NORMAN OK
73072-1810
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-2000
  • Fax: 405-515-2030
Mailing address:
  • Phone: 405-307-6630
  • Fax: 405-307-6660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24604
License Number StateOK

VIII. Authorized Official

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