Healthcare Provider Details

I. General information

NPI: 1952425795
Provider Name (Legal Business Name): PRECISION MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W MAIN ST SUITE 3 PARK C
NORMAN OK
73072-4657
US

IV. Provider business mailing address

3750 W MAIN ST SUITE 3 PARK C
NORMAN OK
73072-4657
US

V. Phone/Fax

Practice location:
  • Phone: 405-364-0261
  • Fax: 405-364-0283
Mailing address:
  • Phone: 405-364-0261
  • Fax: 405-364-0283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number72
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number72
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT ELBERT HEWETT
Title or Position: PRESIDENT
Credential: L-PED
Phone: 405-364-0261