Healthcare Provider Details

I. General information

NPI: 1922058189
Provider Name (Legal Business Name): FUNNELL AND STREBEL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W MEMORIAL RD SUITE 201
OKLAHOMA CITY OK
73120
US

IV. Provider business mailing address

4200 W MEMORIAL RD SUITE 201
OKLAHOMA CITY OK
73120
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-4200
  • Fax: 405-749-4218
Mailing address:
  • Phone: 405-749-4200
  • Fax: 405-749-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number8501
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number22255
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number7582
License Number StateOK

VIII. Authorized Official

Name: MRS. SHERRY STREBEL
Title or Position: OFFICE MANAGER
Credential:
Phone: 405-749-4202