Provider Demographics
NPI:1598847337
Name:NORMAN REGIONAL SPORTS & OCCUPATIONAL MEDICIN
Entity Type:Organization
Organization Name:NORMAN REGIONAL SPORTS & OCCUPATIONAL MEDICIN
Other - Org Name:NRH OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, REVENUE CYCLE
Authorized Official - Prefix:MS
Authorized Official - First Name:MEEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-307-1050
Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-360-6868
Mailing Address - Fax:405-360-9860
Practice Address - Street 1:724 24TH AVE NW
Practice Address - Street 2:SUITE # 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6218
Practice Address - Country:US
Practice Address - Phone:405-360-6868
Practice Address - Fax:405-360-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK400522209Medicare ID - Type Unspecified