Healthcare Provider Details

I. General information

NPI: 1457441180
Provider Name (Legal Business Name): OKLAHOMA CITY EAR, NOSE & THROAT CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 NW 9TH ST SUITE 300
OKLAHOMA CITY OK
73102-1068
US

IV. Provider business mailing address

535 NW 9TH ST SUITE 300
OKLAHOMA CITY OK
73102-1068
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-6027
  • Fax: 405-272-8315
Mailing address:
  • Phone: 405-272-6027
  • Fax: 405-272-8315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL DAVID HUNTER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 405-272-6027