Provider Demographics
NPI:1639161995
Name:RAZOOK, JOEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:C
Last Name:RAZOOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 36TH AVE NW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2922
Mailing Address - Country:US
Mailing Address - Phone:405-579-7664
Mailing Address - Fax:405-321-3193
Practice Address - Street 1:2300 36TH AVE NW
Practice Address - Street 2:SUITE 110
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2922
Practice Address - Country:US
Practice Address - Phone:405-579-7664
Practice Address - Fax:405-321-3193
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19913207W00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100091190AMedicaid
G90614Medicare UPIN