Basic Information
Provider Information
NPI: 1154602662
EntityType: 2
ReplacementNPI:  
OrganizationName: NRHS BEHAVIORAL MEDICINE ASSOCIATES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1330
Address2:  
City: NORMAN
State: OK
PostalCode: 730701330
CountryCode: US
TelephoneNumber: 4053071000
FaxNumber: 4053076660
Practice Location
Address1: 901 N PORTER
Address2:  
City: NORMAN
State: OK
PostalCode: 730716404
CountryCode: US
TelephoneNumber: 4053075555
FaxNumber: 4053075004
Other Information
ProviderEnumerationDate: 08/30/2011
LastUpdateDate: 01/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CARTER
AuthorizedOfficialFirstName: MEEGAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP RS
AuthorizedOfficialTelephone: 4053071000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home