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NPI Code Detail

MEDICARE: OKLAHOMA CITY UNIVERSITY

MEDICARE: OKLAHOMA CITY UNIVERSITY
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
1261QS1000XStudent Health Clinic/Center

General Provider Information

NPI Number : 1699932228
Entity Type Code : Organization
Provider Name (Legal Business Name) : OKLAHOMA CITY UNIVERSITY
Provider Business Mailing Address
First Line : 2501 N BLACKWELDER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-1402
Country : US
Telephone Number : 405-208-5090
Fax Number : 405-208-6016
Provider Business Practice Location Address
First Line : 2501 N BLACKWELDER AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-1402
Country : US
Telephone Number : 405-208-5090
Fax Number : 405-208-6016
Authorized Official
Title or Position : DIRECTOR, STUDENT HEALTH CLINIC
Name : MS. BRENDA JOYCE JOHNSTON
Credential : RN
Telephone Number : 405-208-5090
Provider Enumeration Date : 05/21/2008
Last Update Date : 05/21/2008

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1639591639 — OKLAHOMA CITY UNIVERSITY CAMPUS HEALTH
Practice Location Address:
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Practice Phone: 405-208-5090
Practice Fax: 405-208-6016

Directions to “OKLAHOMA CITY UNIVERSITY ” Practice Location

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