Healthcare Provider Details

I. General information

NPI: 1548513773
Provider Name (Legal Business Name): NORMAN REGIONAL PROVIDERS SPECIALTY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 HEALTHPLEX PKWY STE 200
NORMAN OK
73072-9801
US

IV. Provider business mailing address

3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-2222
  • Fax:
Mailing address:
  • Phone: 405-307-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD D WAGNER
Title or Position: CO-CEO
Credential:
Phone: 405-515-1000