MEDICARE: NORTHWEST OTOLARYNGOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	7794	OK

General Provider Information

NPI Number	:	1649371923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST OTOLARYNGOLOGY

Provider Business Mailing Address
First Line	:	3435 NW 56TH ST
Second Line	:	711A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4448
Country	:	US
Telephone Number	:	405-945-4222
Fax Number	:	405-945-4322

Provider Business Practice Location Address
First Line	:	3435 NW 56TH ST
Second Line	:	711A
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4448
Country	:	US
Telephone Number	:	405-945-4222
Fax Number	:	405-945-4322

Authorized Official
Title or Position	:	COOWNER
Name	:	JERRY D RENFROE
Credential	:	M.D.
Telephone Number	:	405-945-4222

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	02/08/2008

Similar Medicare Providers

1245297894 — SUMEETA M NANDA MD
Practice Location Address:

3435 NW 56TH ST , SUITE 404
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-946-4735
Practice Fax: 405-946-4874

1174594550 — DR. SUSAN J HAKEL MD
Practice Location Address:

3435 NW 56TH ST , SUITE 750
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-945-4900
Practice Fax: 405-945-4901

1598722142 — LINDA J TRUITT MD
Practice Location Address:

3435 NW 56TH ST , SUITE 404
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-946-4735
Practice Fax: 405-946-4874

1053418913 — PERRY M. SANTOS M.D.
Practice Location Address:

3435 NW 56TH ST , BLDG A, SUITE 412
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-945-4325
Practice Fax: 405-945-4327

1801938733 — KAREN MARIE PEARCE GOLD MD PC
Practice Location Address:

3435 NW 56TH ST , SUITE 404
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-373-4340
Practice Fax: 405-373-2950

1336281260 — SUMEETA M NANDA MD PC
Practice Location Address:

3435 NW 56TH ST , SUITE 404
OKLAHOMA CITY, OK
73112-4448

Practice Phone: 405-946-4735
Practice Fax: 405-946-4874

Directions to “NORTHWEST OTOLARYNGOLOGY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.