Provider Demographics
NPI:1326588807
Name:OAKWOOD SPRINGS PHYSICIAN GROUP LLC
Entity Type:Organization
Organization Name:OAKWOOD SPRINGS PHYSICIAN GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDENSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-438-3000
Mailing Address - Street 1:13101 MEMORIAL SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-2226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13101 MEMORIAL SPRINGS CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2226
Practice Address - Country:US
Practice Address - Phone:405-438-3000
Practice Address - Fax:405-751-6496
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKWOOD SPRINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty