Board of Regents of the Univ of Oklahoma-Ou Physicians Adolescent Med

NPI #1013005388 in Okc, Oklahoma

Provider Information

NPI Number: 1013005388
Entity Type: Organization
Organization Name: Board of Regents of the Univ of Oklahoma-Ou Physicians Adolescent Med
Primary Specialty: Clinic/Center
Enumeration Date: Oct 11, 2006
Last Updated: Sep 6, 2012

Practice Location

Address: 1200 CHILDREN'S AVENUE
Address 2: SUITE 7500
City: Okc
State: Oklahoma
ZIP Code: 73104
Phone: (405) 271-2006

Authorized Official

Name: BRIAN MADDY
Title: CHIEF EXECUTIVE OFFICER
Phone: (405) 271-1515

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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