Healthcare Provider Details

I. General information

NPI: 1790065415
Provider Name (Legal Business Name): NRHS INTERNAL MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 N PORTER SUITE 202
NORMAN OK
73071-6446
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-1800
  • Fax: 405-515-1805
Mailing address:
  • Phone: 405-515-1800
  • Fax: 405-515-1805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25637
License Number StateOK

VIII. Authorized Official

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