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Organization

BOARD OF RENGENTS OF THE UNIV OF OKLAHOMA - OU PHYS BREAST INSTITUTE

Active
Other names
OU Physicians Breast Institute
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN MADDY (CHIEF EXECUTIVE OFFICER)
(405) 271-1515
Entity
Organization

Contact information

Practice address
825 NE 10TH ST, OUPB3500, OKLAHOMA CITY, OK 73104-5417
(405) 271-4514
Mailing address
1122 NE 13TH ST, ORI236, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1173440013
DME PALMETTO MEDICARE
OK
Enumeration date
09/19/2006
Last updated
10/05/2009
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