Healthcare Provider Details

I. General information

NPI: 1326456047
Provider Name (Legal Business Name): OKLAHOMA SLEEP ASSOCIATES PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 NW 58TH ST SUITE 310-W
OKLAHOMA CITY OK
73112-4707
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-5337
  • Fax: 405-253-4148
Mailing address:
  • Phone: 405-307-6668
  • Fax: 866-815-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG TERRELL
Title or Position: SENIOR VP, COO
Credential:
Phone: 405-307-1000