Organization
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU PHYSICIANS
Active
Organization
BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P ZUBIALDE MD (EXECUTIVE DEAN)
(405) 271-1515
Entity
Organization
Contact information
Practice address
825 NE 10TH ST, OKLAHOMA CITY, OK 73104-5417
(405) 271-3932
(405) 271-3064
Mailing address
1122 NE 13TH ST, ORI274, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
(405) 271-1001
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744720A
—
OK
05
—
100811290A
—
OK
01
—
647679
MEDICARE DIABETIC PREVENTION PROGRAM
OK
Enumeration date
02/08/2006
Last updated
01/06/2020
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