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KETO WELLNESS AND HORMONE CLINIC NPI 1295383289


NPI Information

NPI: 1295383289
Provider Name: KETO WELLNESS AND HORMONE CLINIC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
900 N PORTER AVE STE 212
NORMAN, OK
ZIP 73071
Phone: (405) 217-2922
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KETO WELLNESS AND HORMONE CLINIC is a specialist in Norman, OK. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. KETO WELLNESS AND HORMONE CLINIC NPI is 1295383289. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

900 N PORTER AVE STE 212
NORMAN, OK
ZIP 73071-485
Phone: (405) 217-2922
Fax: (405) 217-2940

The provider's authorized official is John Ray Resneder .
The authorized official title is Owner and has the following contact phone number (405) 217-2922.

The enumeration date for this NPI number is 9/3/2019 and was last updated on 9/3/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11316989205MEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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