Healthcare Provider Details
I. General information
NPI: 1942217815
Provider Name (Legal Business Name): THE PERINATAL CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4140 W MEMORIAL RD STE 321
OKLAHOMA CITY OK
73120
US
IV. Provider business mailing address
4140 W MEMORIAL RD STE 321
OKLAHOMA CITY OK
73120-8300
US
V. Phone/Fax
- Phone: 405-748-4726
- Fax: 405-607-8497
- Phone: 405-748-4726
- Fax: 405-607-8497
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | E9215 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 18898 |
| License Number State | OK |
VIII. Authorized Official
Name:
DANA
LYNN
CUMMINGS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 405-748-4726