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General NPI Number Information
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NPI Number | 1326234584
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Entity Type | Organization
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Legal Business Name | NORMAN SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 500 E ROBINSON ST 2300
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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 | 405-329-4102
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Fax | 405-364-3476
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Provider Business Mailing Address
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Address Line | 500 E ROBINSON ST 2300
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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 | 405-329-4102
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Fax | 405-364-3476
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Authorized Official
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Title or Position | MEMBER
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Name | MR. TOM SHI CONNALLY
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Credential | MD
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Telephone | 405-329-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 17833
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 24274
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 26881
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 9306
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R0054197
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 23363
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License Number State | OK
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