Healthcare Provider Details

I. General information

NPI: 1619914611
Provider Name (Legal Business Name): JOSE-MARIE ALBERT EL-AMM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 NW EXPRESSWAY SUITE 700
OKLAHOMA CITY OK
73112-4493
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE SUITE 280
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3816
  • Fax: 405-713-7465
Mailing address:
  • Phone: 405-949-3816
  • Fax: 405-713-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number26052
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: