Provider Demographics
NPI:1942289939
Name:NORMAN, CYNTHIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANN
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 JACKIE RD
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1566
Mailing Address - Country:US
Mailing Address - Phone:580-252-3466
Mailing Address - Fax:580-252-8265
Practice Address - Street 1:1315 JACKIE RD
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1566
Practice Address - Country:US
Practice Address - Phone:580-252-3466
Practice Address - Fax:580-252-8265
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10956207Q00000X
TXE4569207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100170910AMedicaid
OK100170910AMedicaid