Healthcare Provider Details

I. General information

NPI: 1548195936
Provider Name (Legal Business Name): MR. ADAM HURRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 ROYAL AVE
OKLAHOMA CITY OK
73108-2033
US

IV. Provider business mailing address

4909 NW 163RD ST
EDMOND OK
73013-3292
US

V. Phone/Fax

Practice location:
  • Phone: 405-283-3383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: