Healthcare Provider Details

I. General information

NPI: 1316044027
Provider Name (Legal Business Name): PEDIATRIX MEDICAL GROUP OF OKLAHOMA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US

IV. Provider business mailing address

1301 CONCORD TER
SUNRISE FL
33323-2843
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-6051
  • Fax: 405-949-6977
Mailing address:
  • Phone: 954-384-0175
  • Fax: 954-851-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN M PITZER
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 954-384-0175