Healthcare Provider Details

I. General information

NPI: 1619196144
Provider Name (Legal Business Name): OMNET OCCUPATIONAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N MERIDIAN AVE
OKLAHOMA CITY OK
73107-5723
US

IV. Provider business mailing address

520 N MERIDIAN AVE
OKLAHOMA CITY OK
73107-5723
US

V. Phone/Fax

Practice location:
  • Phone: 405-942-9000
  • Fax: 405-942-9001
Mailing address:
  • Phone: 405-942-9000
  • Fax: 405-942-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY ANN WILLIAMS
Title or Position: DIRECTOR OF MARKETING
Credential:
Phone: 405-942-9000