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General NPI Number Information
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NPI Number | 1477670529
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Entity Type | Organization
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Legal Business Name | OKLAHOMA STATE DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 4615 W LAKEVIEW RD
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City | STILLWATER
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State | OK
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Zip | 74075-2173
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Country | US
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Telephone | 405-564-7750
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Fax |
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Provider Business Mailing Address
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Address Line | 123 ROBERT S KERR AVE STE 1702
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-6406
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Country | US
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Telephone | 405-426-8650
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Fax | 405-900-7598
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Authorized Official
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Title or Position | DIRECTOR
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Name | JENNIFER HAN
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Credential | PH.D.
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Telephone | 405-426-8139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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