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General NPI Number Information
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NPI Number | 1265566905
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Entity Type | Organization
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Legal Business Name | BROOKHAVEN MEDICAL WOMEN'S CENTER
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 809 N FINDLAY AVE 100
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City | NORMAN
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State | OK
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Zip | 73071
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Country | US
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Telephone | 405-364-0643
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Fax | 405-364-0502
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Provider Business Mailing Address
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Address Line | 809 N FINDLAY AVE 100
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City | NORMAN
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State | OK
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Zip | 73071
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Country | US
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Telephone | 405-364-0643
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Fax | 405-364-0502
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SHELBA J BETHEL
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Credential | M.D.
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Telephone | 405-364-5725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8481
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License Number State | OK
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