Healthcare Provider Details

I. General information

NPI: 1710132782
Provider Name (Legal Business Name): OKLAHOMA STATE DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1299
US

IV. Provider business mailing address

1000 NE 10TH ST
OKLAHOMA CITY OK
73117-1299
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M CRUTCHER
Title or Position: COMMISSIONER OF HEALTH
Credential: M.D.
Phone: 405-271-4200