Provider Demographics
NPI:1073007811
Name:OZOYA, RAPHAEL IRIAFE
Entity Type:Individual
Prefix:
First Name:RAPHAEL
Middle Name:IRIAFE
Last Name:OZOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 PEREGRINE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8119
Mailing Address - Country:US
Mailing Address - Phone:405-885-7777
Mailing Address - Fax:
Practice Address - Street 1:813 PEREGRINE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8119
Practice Address - Country:US
Practice Address - Phone:405-885-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator