Provider Demographics
NPI:1922058189
Name:FUNNELL AND STREBEL INC
Entity Type:Organization
Organization Name:FUNNELL AND STREBEL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STREBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-749-4202
Mailing Address - Street 1:4200 W MEMORIAL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-749-4200
Mailing Address - Fax:405-749-4218
Practice Address - Street 1:4200 W MEMORIAL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-749-4200
Practice Address - Fax:405-749-4218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8501207V00000X
OK22255207V00000X
OK7582207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100729060AMedicaid
OK100729060AMedicaid
OK=========001OtherBLUE CROSS BLUE SHIELD