Provider Demographics
NPI:1952425795
Name:PRECISION MEDICAL, PLLC
Entity type:Organization
Organization Name:PRECISION MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ELBERT
Authorized Official - Last Name:HEWETT
Authorized Official - Suffix:
Authorized Official - Credentials:L-PED
Authorized Official - Phone:405-364-0261
Mailing Address - Street 1:3750 W MAIN ST
Mailing Address - Street 2:SUITE 3 PARK C
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4657
Mailing Address - Country:US
Mailing Address - Phone:405-364-0261
Mailing Address - Fax:405-364-0283
Practice Address - Street 1:3750 W MAIN ST
Practice Address - Street 2:SUITE 3 PARK C
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4657
Practice Address - Country:US
Practice Address - Phone:405-364-0261
Practice Address - Fax:405-364-0283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK72332BC3200X, 335E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200118290AMedicaid
OK5932160001Medicare NSC