Healthcare Provider Details

I. General information

NPI: 1083985600
Provider Name (Legal Business Name): UHS OKLAHOMA CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 NE 50TH ST
OKLAHOMA CITY OK
73141-9118
US

IV. Provider business mailing address

6501 NE 50TH ST
OKLAHOMA CITY OK
73141-9118
US

V. Phone/Fax

Practice location:
  • Phone: 405-605-6111
  • Fax: 405-424-0457
Mailing address:
  • Phone: 405-605-6111
  • Fax: 405-424-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4246
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1444
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number47346
License Number StateOK

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300