Healthcare Provider Details

I. General information

NPI: 1508144411
Provider Name (Legal Business Name): THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N PHILLIPS AVE SUITE 12109
OKLAHOMA CITY OK
73104-4600
US

IV. Provider business mailing address

1200 N PHILLIPS AVE SUITE 12109
OKLAHOMA CITY OK
73104-4600
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8685
  • Fax: 405-271-8697
Mailing address:
  • Phone: 405-271-8685
  • Fax: 405-271-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number StateOK

VIII. Authorized Official

Name: MS. LAUREN NICOLE AHLES
Title or Position: GENETIC COUNSELOR
Credential: M.S.
Phone: 405-271-8685