Healthcare Provider Details

I. General information

NPI: 1548835499
Provider Name (Legal Business Name): OKC BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 NW 13TH ST
OKLAHOMA CITY OK
73106-6827
US

IV. Provider business mailing address

814 NW 13TH ST
OKLAHOMA CITY OK
73106-6827
US

V. Phone/Fax

Practice location:
  • Phone: 405-413-7337
  • Fax:
Mailing address:
  • Phone: 405-413-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TARYN LEANN GOODWIN
Title or Position: LICENSED MIDWIFE, OWNER
Credential: CPM, LM
Phone: 405-413-7337