MEDICARE: TROY R NORRED MD PC

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	2085R0202X	Diagnostic Radiology Physician	20073	OK
2	2085U0001X	Diagnostic Ultrasound Physician	20073	OK
3	2085N0904X	Nuclear Radiology Physician	20073	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912111238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROY R NORRED MD PC

Provider Business Mailing Address
First Line	:	3545 NW 58TH ST
Second Line	:	STE 450
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-4726
Country	:	US
Telephone Number	:	580-272-0715
Fax Number	:	580-272-0771

Provider Business Practice Location Address
First Line	:	3012 ARLINGTON ST
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-3073
Country	:	US
Telephone Number	:	405-948-4040
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PAUL SZYMANSKI
Credential	:
Telephone Number	:	405-917-3528

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/07/2009

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