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General NPI Number Information
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NPI Number | 1184185803
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Entity Type | Organization
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Legal Business Name | BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU PHYSICIANS
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 1000 N LINCOLN BLVD STE 1308
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-3252
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Country | US
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Telephone | 405-421-2959
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Fax | 405-271-2836
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Provider Business Mailing Address
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Address Line | 1122 NE 13TH ST # 274
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1039
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Country | US
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Telephone | 405-271-1515
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Fax | 405-271-1001
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Authorized Official
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Title or Position | EXECUTIVE DEAN
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Name | JOHN P ZUBIALDE
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Credential | MD
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Telephone | 405-271-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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