1326456047 NPI number — OKLAHOMA SLEEP ASSOCIATES PHYSICIAN SERVICES

Table of content: (NPI 1326456047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326456047 NPI number — OKLAHOMA SLEEP ASSOCIATES PHYSICIAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OKLAHOMA SLEEP ASSOCIATES PHYSICIAN SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1326456047
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1330
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73070-1330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-307-6668
Provider Business Mailing Address Fax Number:
866-815-0086

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3555 NW 58TH ST
Provider Second Line Business Practice Location Address:
SUITE 310-W
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73112-4707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-307-5337
Provider Business Practice Location Address Fax Number:
405-253-4148
Provider Enumeration Date:
07/25/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TERRELL
Authorized Official First Name:
GREG
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VP, COO
Authorized Official Telephone Number:
405-307-1000

Provider Taxonomy Codes

  • Taxonomy code: 207QS1201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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