Healthcare Provider Details

I. General information

NPI: 1407381239
Provider Name (Legal Business Name): JOEL M PRINCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2017
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

825 NE 10TH ST
OKLAHOMA CITY OK
73104-5417
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2220
  • Fax:
Mailing address:
  • Phone: 405-271-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number39414
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6699-851
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: