Organization · Type 2 NPI

State of Oklahoma Medical Center LLC

General Practice Physician · Oklahoma City, OK

NPI number 1740177401 Active

Practice location

101 Park Ave Ste 1300
Oklahoma City, OK 73102-7216

Call (510) 456-8143 Map

Mailing address

4570 S Eastern Ave Ste 28
Las Vegas, NV 89119-6183

Specialties and licenses

TaxonomyCodeLicense
Behavioral Neurology & Neuropsychiatry Physician 2084B0040XNone listed
General Practice Physician Primary 208D00000XNone listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

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About NPI 1740177401

State of Oklahoma Medical Center LLC's National Provider Identifier is 1740177401, issued on Jun 23, 2025. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Oklahoma City, OK. The record was last updated on Jun 23, 2025.