Northern Oklahoma Regional Pediatric Clinic, Pllc

LBN: Northern Oklahoma Regional Pediatric Clinic, Pllc
Northern Oklahoma Regional Pediatric Clinic, Pllc is an health care organization with primary practice located at 415 Fairview Ave Ste. 100, Ponca City OK 74601-1923. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Northern Oklahoma Regional Pediatric Clinic, Pllc can be contacted via phone (580) 765-5569, or through Pollak, Chris W via phone (580) 765-5569.

Contact Information

Primary practice address
415 Fairview Ave Ste. 100 Ponca City OK 74601-1923
Phone: (580) 765-5569
Fax: (580) 765-2020
Website:
Map and Directions
Authorized official contact:
Name: Pollak, Chris W
Phone: (580) 765-5569

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X

Profile Details

NPI number 1053486431
LBN Legal business name Northern Oklahoma Regional Pediatric Clinic, Pllc
DBA Doing business as
Authorized official Pollak, Chris W
Entity Organization
Organization subpart 1 No
Enumeration date Nov 21st, 2006
Last updated May 12th, 2017 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053486431 NPPES
Oklahoma MEDICAID 100749170C

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