Central Oklahoma Clinical Associates, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24137 Issued in OK

Legal business name

CENTRAL OKLAHOMA CLINICAL ASSOCIATES, PLLC

Doing business as

George R. Petry, MD

Practice address

9405 North May Avenue
Oklahoma City, OK 73120

Phone

(405) 936-0504

Fax

(405) 936-0561

NPI assigned

Jun 15, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George R Petry, MD

Title

Owner/Physician

Phone

(405) 936-0504

Specialties & licenses 1

Addresses

Other names 1

• George R. Petry, MD Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1215222583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 NORTH MAY AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-936-0504",
            "fax_number": "405-936-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 NORTH MAY AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-936-0504",
            "fax_number": "405-936-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OKLAHOMA CLINICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "405-936-0504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George R. Petry, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Oklahoma American Indian Health Council, Inc.
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• Central Oklahoma Eye Associates, P.C.
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• Central Oklahoma United Methodist Retirement Facility Inc

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.