Healthcare Provider Details

I. General information

NPI: 1336337393
Provider Name (Legal Business Name): NORMAN INTERVENTIONAL PAIN MANAGEMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 W ROCK CREEK RD SUITE 100
NORMAN OK
73072-2202
US

IV. Provider business mailing address

3650 W ROCK CREEK RD SUITE 100
NORMAN OK
73072-2202
US

V. Phone/Fax

Practice location:
  • Phone: 405-701-3418
  • Fax: 405-701-3451
Mailing address:
  • Phone: 405-701-3418
  • Fax: 405-701-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON EDWARD LEONARD
Title or Position: PRESIDENT
Credential: MD
Phone: 405-701-3418