Healthcare Provider Details
I. General information
NPI: 1770993701
Provider Name (Legal Business Name): OBGYN CARE OF OKLAHOMA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2014
Last Update Date: 06/18/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3427 NW 50TH ST 2ND FLOOR
OKLAHOMA CITY OK
73112
US
IV. Provider business mailing address
3427 NW 50TH ST 2ND FLOOR
OKLAHOMA CITY OK
73112
US
V. Phone/Fax
- Phone: 405-930-3496
- Fax: 405-702-8665
- Phone: 405-930-3496
- Fax: 405-702-8665
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 27317 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
SHAURIN
N
PATEL
Title or Position: OWNER
Credential: MD
Phone: 405-706-7694