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General NPI Number Information
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NPI Number | 1609460328
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Entity Type | Organization
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Legal Business Name | SCOTT M PROCTOR MD PC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 02/23/2021
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Provider Practice Location 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 | 405-313-9368
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Fax |
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Provider Business Mailing Address
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Address Line | 6617 NE 113TH ST
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City | EDMOND
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State | OK
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Zip | 73013-8354
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Country | US
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Telephone | 405-834-1296
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RONDA JILL PROCTOR
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Credential | RN
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Telephone | 405-834-1296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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