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General NPI Number Information
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NPI Number | 1538927488
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Entity Type | Organization
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Legal Business Name | NORMAN FOOT AND ANKLE CLINIC PC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1006 24TH AVE NW STE 110
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City | NORMAN
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State | OK
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Zip | 73069-6344
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Country | US
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Telephone | 405-321-6984
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Fax | 405-340-7077
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Provider Business Mailing Address
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Address Line | 2553 S KELLY AVE STE 100
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City | EDMOND
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State | OK
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Zip | 73013-3894
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Country | US
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Telephone | 405-321-6984
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY SAMANTHA SPANN
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Credential |
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Telephone | 405-317-2990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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