Provider Demographics
NPI:1013045301
Name:JOEL C RAZOOK MD P.C.
Entity Type:Organization
Organization Name:JOEL C RAZOOK MD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAZOOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-579-7664
Mailing Address - Street 1:2300 36TH AVE NW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2922
Mailing Address - Country:US
Mailing Address - Phone:405-579-7664
Mailing Address - Fax:405-321-3193
Practice Address - Street 1:2300 36TH AVE NW
Practice Address - Street 2:SUITE 110
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2922
Practice Address - Country:US
Practice Address - Phone:405-579-7664
Practice Address - Fax:405-321-3193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19913207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100091190AMedicaid
OK440764268Medicare ID - Type Unspecified
OK100091190AMedicaid