Healthcare Provider Details

I. General information

NPI: 1861422628
Provider Name (Legal Business Name): RANDALL M SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 NE 13TH ST STE 200
OKLAHOMA CITY OK
73104-5024
US

IV. Provider business mailing address

750 NE 13TH, SUITE 200 COLLEGE OF MEDICINE THE OU HEALTH SCIENCES CENTER - DEPT OF ANESTHESIOLOGY
OKLAHOMA CITY OK
73104
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4351
  • Fax: 405-271-8695
Mailing address:
  • Phone: 405-271-4351
  • Fax: 405-271-8695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number35080922
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: