Provider Demographics
NPI:1013539774
Name:FAMILY WELLNESS CENTER OF NORMAN LLC
Entity Type:Organization
Organization Name:FAMILY WELLNESS CENTER OF NORMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-360-2827
Mailing Address - Street 1:2760 WASHINGTON DR STE 110
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1009
Mailing Address - Country:US
Mailing Address - Phone:405-360-2827
Mailing Address - Fax:405-283-1124
Practice Address - Street 1:2760 WASHINGTON DR STE 110
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1009
Practice Address - Country:US
Practice Address - Phone:405-360-2827
Practice Address - Fax:405-283-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty