Provider Demographics
NPI:1548372626
Name:BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA--OU HEALTH SERVICES
Entity type:Organization
Organization Name:BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA--OU HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-325-4611
Mailing Address - Street 1:620 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73019-3146
Mailing Address - Country:US
Mailing Address - Phone:405-325-4611
Mailing Address - Fax:405-325-7065
Practice Address - Street 1:620 ELM AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73019-3142
Practice Address - Country:US
Practice Address - Phone:405-325-4611
Practice Address - Fax:405-325-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health