Basic Information
Provider Information
NPI: 1548212186
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DURICA
FirstName: SHERRI
MiddleName: LYNN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4401 W MEMORIAL RD
Address2: 140
City: OKLAHOMA CITY
State: OK
PostalCode: 731341785
CountryCode: US
TelephoneNumber: 4057523162
FaxNumber: 4059365211
Practice Location
Address1: 701 E ROBINSON ST
Address2: SUITE A 100
City: NORMAN
State: OK
PostalCode: 730716625
CountryCode: US
TelephoneNumber: 4053214644
FaxNumber: 4054471061
Other Information
ProviderEnumerationDate: 05/16/2006
LastUpdateDate: 04/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X16564OKY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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