=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699902593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIANNE CHAMBERS MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2009
-----------------------------------------------------
Last Update Date | 11/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3440 RC LUTTRELL DR STE 200
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73072-9005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-360-1264
-----------------------------------------------------
Fax | 405-321-8683
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3440 RC LUTTRELL DR STE 200
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73072-9005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-360-1264
-----------------------------------------------------
Fax | 405-321-8683
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. DIANNE CHAMBERS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 405-360-1264
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 20216
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------