Basic Information
| Provider Information | |||||||||
| NPI: | 1326456047 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OKLAHOMA SLEEP ASSOCIATES PHYSICIAN SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1330 | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730701330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053076668 | ||||||||
| FaxNumber: | 8668150086 | ||||||||
| Practice Location | |||||||||
| Address1: | 3555 NW 58TH ST | ||||||||
| Address2: | SUITE 310-W | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731124707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053075337 | ||||||||
| FaxNumber: | 4052534148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2014 | ||||||||
| LastUpdateDate: | 07/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | TERRELL | ||||||||
| AuthorizedOfficialFirstName: | GREG | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VP, COO | ||||||||
| AuthorizedOfficialTelephone: | 4053071000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS1201X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine |
No ID Information.