Healthcare Provider Details

I. General information

NPI: 1386892230
Provider Name (Legal Business Name): NORMAN ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N PORTER AVE STE 100
NORMAN OK
73071-6650
US

IV. Provider business mailing address

1125 N PORTER AVE SUITE 206
NORMAN OK
73071-6446
US

V. Phone/Fax

Practice location:
  • Phone: 405-366-0969
  • Fax: 405-366-1839
Mailing address:
  • Phone: 405-366-8619
  • Fax: 405-366-1839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT HOLBROOK
Title or Position: MARKET PRESIDENT
Credential: M.D.
Phone: 405-366-8619