Provider Demographics
NPI:1316382930
Name:NORMAN REGIONAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:NORMAN REGIONAL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGY PRACTITIONER ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PODANY
Authorized Official - Suffix:
Authorized Official - Credentials:BSRT, CBRPA
Authorized Official - Phone:405-343-6341
Mailing Address - Street 1:1201 TORREY PINES RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2027
Mailing Address - Country:US
Mailing Address - Phone:405-343-6341
Mailing Address - Fax:
Practice Address - Street 1:901 N PORTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6404
Practice Address - Country:US
Practice Address - Phone:405-307-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11OK1439243U00000X
OK4158812471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner AssistantGroup - Multi-Specialty
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Multi-Specialty