Provider Demographics
NPI:1538927488
Name:NORMAN FOOT AND ANKLE CLINIC PC
Entity type:Organization
Organization Name:NORMAN FOOT AND ANKLE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-317-2990
Mailing Address - Street 1:2553 S KELLY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3894
Mailing Address - Country:US
Mailing Address - Phone:405-321-6984
Mailing Address - Fax:
Practice Address - Street 1:1006 24TH AVE NW STE 110
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6344
Practice Address - Country:US
Practice Address - Phone:405-321-6984
Practice Address - Fax:405-340-7077
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMAN FOOT AND ANKLE CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty