Provider Demographics
NPI:1063927408
Name:CLASSEN FAMILY PRACTICE LLC
Entity type:Organization
Organization Name:CLASSEN FAMILY PRACTICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TORBATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-701-7111
Mailing Address - Street 1:2818 CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4059
Mailing Address - Country:US
Mailing Address - Phone:405-310-3400
Mailing Address - Fax:405-701-6158
Practice Address - Street 1:1025 SW 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2404
Practice Address - Country:US
Practice Address - Phone:405-378-2001
Practice Address - Fax:405-445-7660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLASSEN FAMILY PRACTICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-07
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty