Northern Oklahoma Regional Pediatric Clinic, Pllc
Pediatric Adolescent Medicine
Northern Oklahoma Regional Pediatric Clinic, Pllc is a Ponca City, Oklahoma based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
415 Fairview Ave, Ste. 100, Ponca City, Oklahoma - 74601-1923. They can be contacted on phone at
580-765-5569 and fax number 580-765-2020.
NPI number (Unique professional ID) for Northern Oklahoma Regional Pediatric Clinic, Pllc is
1053486431 which was assigned by NPPES on 21 Nov, 2006 and it was last updated on 12 May, 2017.
Northern Oklahoma Regional Pediatric Clinic, Pllc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Northern Oklahoma Regional Pediatric Clinic, Pllc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Northern Oklahoma Regional Pediatric Clinic, Pllc |
|---|
Business Address:
Northern Oklahoma Regional Pediatric Clinic, Pllc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 415 Fairview Ave, Ste. 100
Ponca City, OK, 74601-1923
United States |
|---|
| Phone Number : | 580-765-5569 |
|---|
| Fax Number : | 580-765-2020 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1053486431 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 21 Nov, 2006 |
|---|
| Last Updated On : | 12 May, 2017 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Chrisw Pollak |
|---|
| Official Title or Position : | ADMINISTRATOR |
|---|
| Phone Number : | 580-765-5569 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Northern Oklahoma Regional Pediatric Clinic, Pllc are as mentioned. Primary taxonomy code for Northern Oklahoma Regional Pediatric Clinic, Pllc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Northern Oklahoma Regional Pediatric Clinic, Pllc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 100749170C | MEDICAID | OK | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 415 Fairview Ave, Ste. 100
Ponca City, OK, 74601-1923
United States |
|---|
| Phone Number : | 580-765-5569 |
|---|
| Fax Number : | 580-765-2020 |
|---|
Business Location:
Patients can refer following map for directions to
Northern Oklahoma Regional Pediatric Clinic, Pllc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.