Organization
BOARD OF REGENTS OF THE UNIV OF OKLAHOMA-OU PHYS RESIDENTS CLINIC (INT
Active
Other names
OU Physicians Residents Clinic (Internal Medicine)
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P ZUBIALDE MD (EXECUTIVE DEAN)
(405) 271-1515
Entity
Organization
Contact information
Practice address
711 STANTON L YOUNG BLVD STE 524, OKLAHOMA CITY, OK 73104
(405) 271-3900
Mailing address
1122 NE 13TH ST # 274, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
(405) 271-1001
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744720G
—
OK
05
—
200284240A
—
OK
Enumeration date
10/04/2006
Last updated
01/06/2020
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