Basic Information
| Provider Information | |||||||||
| NPI: | 1538584867 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OU PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 NE 10TH ST | ||||||||
| Address2: | SUITE #5050 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052718707 | ||||||||
| FaxNumber: | 4052712976 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 NE 10TH ST | ||||||||
| Address2: | SUITE #5050 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052718707 | ||||||||
| FaxNumber: | 4052712976 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2014 | ||||||||
| LastUpdateDate: | 02/24/2014 | ||||||||
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| AuthorizedOfficialLastName: | FEUERBORN | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4052718001 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | R0093104 | OK | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.