Diaz, Glen

Diaz, Glen is an individual health care provider with primary practice located at 500 E Robinson St Suite 2600, Norman OK 73071-6697. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Diaz, Glen can be contacted via phone (405) 364-6432.

Contact Information

Primary practice address
500 E Robinson St Suite 2600 Norman OK 73071-6697
Phone: (405) 364-6432
Fax: (405) 364-0090
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R0068622 Oklahoma

Profile Details

NPI number 1780773952
LBN Legal business name Diaz, Glen
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Dec 6th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780773952 NPPES
Oklahoma MEDICAID 200053800A

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