Healthcare Provider Details

I. General information

NPI: 1992822241
Provider Name (Legal Business Name): OKLAHOMA STATE DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1207
US

IV. Provider business mailing address

123 ROBERT S KERR AVE STE 1702
OKLAHOMA CITY OK
73102-6406
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-9663
  • Fax: 405-271-1728
Mailing address:
  • Phone: 405-426-8650
  • Fax: 405-271-1728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HAN
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 405-426-8139