Organization
EAGLE COMMUNITY CLINIC LLC
Active
Parent organization
OKLAHOMA SPORTS AND ORTHOPEDICS INSTITUTE PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OKLAHOMA SPORTS AND ORTHOPEDICS INSTITUTE PLLC
Authorized official
BRANDON L PENICK (DIRECTOR OF REIMBURSEMENT)
(405) 360-6764
Entity
Organization
Contact information
Practice address
13800 BENSON RD, 202, EDMOND, OK 73013-6422
(405) 418-3077
(405) 418-3076
Mailing address
PO BOX 5995, NORMAN, OK 73070-5995
(405) 360-6764
(405) 360-6769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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