Primarypractice Llc | |
1125 N Porter Ave Ste 101 Norman OK 73071-6443 | |
(405) 364-0630 | |
(405) 364-0760 |
Full Name | Primarypractice Llc |
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Speciality | Internal Medicine |
Location | 1125 N Porter Ave Ste 101, Norman, Oklahoma |
Authorized Official Name and Position | Kumar B Ennamuri (OWNER/PRESIDENT) |
Authorized Official Contact | 4058202586 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Primarypractice Llc 1125 N Porter Ave Ste 101 Norman OK 73071-6443 Ph: (405) 364-0630 | Primarypractice Llc 1125 N Porter Ave Ste 101 Norman OK 73071-6443 Ph: (405) 364-0630 |
NPI Number | 1932787926 |
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Provider Enumeration Date | 03/31/2021 |
Last Update Date | 03/31/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932787926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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