Provider Demographics
NPI:1396825261
Name:NED D. HEMRIC., JR., M.D., P.C.
Entity Type:Organization
Organization Name:NED D. HEMRIC., JR., M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:HEMRIC
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:405-601-0300
Mailing Address - Street 1:3435 NW 56TH ST
Mailing Address - Street 2:#707
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4448
Mailing Address - Country:US
Mailing Address - Phone:405-601-0300
Mailing Address - Fax:405-601-0303
Practice Address - Street 1:3435 NW 56TH ST
Practice Address - Street 2:#707
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-601-0300
Practice Address - Fax:405-601-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20732208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1073577029OtherPERSONAL NPI
OK1073577029OtherPERSONAL NPI