Provider Demographics
NPI:1972991081
Name:TROY R NORRED MD PC
Entity Type:Organization
Organization Name:TROY R NORRED MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:R
Authorized Official - Last Name:NORRED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-272-0715
Mailing Address - Street 1:3012 ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-3073
Mailing Address - Country:US
Mailing Address - Phone:580-272-0715
Mailing Address - Fax:580-272-0771
Practice Address - Street 1:3012 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-3073
Practice Address - Country:US
Practice Address - Phone:580-272-0715
Practice Address - Fax:580-272-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20073207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty