Provider Demographics
NPI:1528642642
Name:OU HEALTH PARTNERS, INC
Entity type:Organization
Organization Name:OU HEALTH PARTNERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN EXECUTIVE
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:MANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-397-2503
Mailing Address - Street 1:1200 CHILDRENS AVE FL 11
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4637
Mailing Address - Country:US
Mailing Address - Phone:405-764-7066
Mailing Address - Fax:405-271-1001
Practice Address - Street 1:1200 CHILDRENS AVE STE 11200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-3932
Practice Address - Fax:405-271-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100758710AMedicaid