Healthcare Provider Details

I. General information

NPI: 1134869548
Provider Name (Legal Business Name): ORTHO CENTRAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD STE 104
NORMAN OK
73072-1810
US

IV. Provider business mailing address

901 N PORTER AVE
NORMAN OK
73071-6404
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-6764
  • Fax:
Mailing address:
  • Phone: 405-307-1000
  • Fax: 405-307-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY R SPLITT JR.
Title or Position: CEO
Credential:
Phone: 405-515-1022