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General NPI Number Information
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NPI Number | 1164432282
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Entity Type | Organization
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Legal Business Name | NORMAN OSTEOPATHIC PRIMARYCARE
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 E ROBINSON ST
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City | NORMAN
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State | OK
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Zip | 73071-6697
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Country | US
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Telephone | 405-360-4836
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Fax | 405-360-7177
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | NORMAN
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State | OK
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Zip | 73070-0429
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Country | US
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Telephone | 405-329-3149
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Fax | 405-329-2987
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER EDGE
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Credential | D.O.
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Telephone | 405-360-4836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2518
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License Number State | OK
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