Healthcare Provider Details

I. General information

NPI: 1922623271
Provider Name (Legal Business Name): KATELYN GERTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 HEALTHPLEX DR
NORMAN OK
73072-1043
US

IV. Provider business mailing address

3231 HEALTHPLEX DR
NORMAN OK
73072-1043
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-5114
  • Fax:
Mailing address:
  • Phone: 405-321-5114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50395
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: