Provider Demographics
NPI:1063466654
Name:OU MEDICINE INC.
Entity Type:Organization
Organization Name:OU MEDICINE INC.
Other - Org Name:OU HEALTH PHARMACY OU HEALTH FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-271-5911
Mailing Address - Street 1:900 NE 10TH ST
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5420
Mailing Address - Country:US
Mailing Address - Phone:405-271-2333
Mailing Address - Fax:405-271-2770
Practice Address - Street 1:900 NE 10TH ST
Practice Address - Street 2:SUITE 1101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5420
Practice Address - Country:US
Practice Address - Phone:405-271-2333
Practice Address - Fax:405-271-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OK138833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100243290AMedicaid
2074778OtherPK
OK100243290BMedicaid
2074778OtherPK