Healthcare Provider Details

I. General information

NPI: 1235169996
Provider Name (Legal Business Name): NSLMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 N SHARTEL AVE SUITE 905
OKLAHOMA CITY OK
73103-2400
US

IV. Provider business mailing address

1211 N SHARTEL AVE 905
OKLAHOMA CITY OK
73103-2400
US

V. Phone/Fax

Practice location:
  • Phone: 405-236-0300
  • Fax: 405-236-0100
Mailing address:
  • Phone: 405-236-0300
  • Fax: 405-236-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: NORMAN S LEVINE
Title or Position: PRESIDENT
Credential: MD
Phone: 405-236-0300