Provider Demographics
NPI:1902111602
Name:OU HEALTH ACCESS NETWORK
Entity Type:Organization
Organization Name:OU HEALTH ACCESS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, HEALTH ACCESS NETWORK
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-660-3095
Mailing Address - Street 1:4502 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-9923
Mailing Address - Country:US
Mailing Address - Phone:918-660-3095
Mailing Address - Fax:918-660-3090
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-9923
Practice Address - Country:US
Practice Address - Phone:918-660-3095
Practice Address - Fax:918-660-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty