Healthcare Provider Details

I. General information

NPI: 1891836052
Provider Name (Legal Business Name): OHC OF OKLAHOMA, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S QUADRUM DR
OKLAHOMA CITY OK
73108-1110
US

IV. Provider business mailing address

PO BOX 75410
OKLAHOMA CITY OK
73147-0410
US

V. Phone/Fax

Practice location:
  • Phone: 405-942-8454
  • Fax: 405-949-9352
Mailing address:
  • Phone: 972-364-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT HASSETT
Title or Position: SR VP, CMO
Credential: DO
Phone: 972-364-8000