Healthcare Provider Details

I. General information

NPI: 1548372626
Provider Name (Legal Business Name): BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA--OU HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 ELM AVE
NORMAN OK
73019-3142
US

IV. Provider business mailing address

620 ELM AVE
NORMAN OK
73019-3146
US

V. Phone/Fax

Practice location:
  • Phone: 405-325-4611
  • Fax: 405-325-7065
Mailing address:
  • Phone: 405-325-4611
  • Fax: 405-325-7065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM R. WAYNE
Title or Position: DIRECTOR OF HEALTH SERVICES
Credential: PHD
Phone: 405-325-4611