1750491734 NPI number — MR. RON S NOFZIGER MS LPC LMFT OK

Table of content: MR. RON S NOFZIGER MS LPC LMFT OK (NPI 1750491734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750491734 NPI number — MR. RON S NOFZIGER MS LPC LMFT OK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NOFZIGER
Provider First Name:
RON
Provider Middle Name:
S
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS LPC LMFT OK
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750491734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3720 SO URBANA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-579-6212
Provider Business Mailing Address Fax Number:
918-579-6232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3223 E 31ST STREET
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74105-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-749-6935
Provider Business Practice Location Address Fax Number:
918-579-6232
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  182 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 635 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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