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General NPI Number Information
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NPI Number | 1548398274
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Entity Type | Organization
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Legal Business Name | NORMAN REGIONAL PROVIDERS PRIMARY CARE
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 500 E ROBINSON ST STE 2400
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City | NORMAN
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State | OK
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Zip | 73071-6684
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Country | US
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Telephone | 405-515-0380
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 HEALTHPLEX PKWY
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City | NORMAN
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State | OK
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Zip | 73072-9749
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Country | US
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Telephone | 405-307-1000
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Fax |
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Authorized Official
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Title or Position | CO-CEO
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Name | RICHARD D WAGNER
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Credential |
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Telephone | 405-515-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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