Healthcare Provider Details

I. General information

NPI: 1861606428
Provider Name (Legal Business Name): CENTRAL OK OBGYN ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD SUITE 205
NORMAN OK
73072-1810
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-793-2229
  • Fax: 405-912-3579
Mailing address:
  • Phone: 405-793-2229
  • Fax: 405-912-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

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