Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northern Oklahoma Regional Pediatric Clinic, PLLC

Organization Pediatric Adolescent Medicine Physician · NPI 1053486431

Northern Oklahoma Regional Pediatric Clinic, PLLC is a Pediatric Adolescent Medicine Physician in Ponca City, Oklahoma. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

415 Fairview Ave Ste 100
Ponca City, OK 74601-1923
Phone: (580) 765-5569
Fax: (580) 765-2020
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X

Record details

NPI number1053486431
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chris Pollak — Administrator · (580) 765-5569
NPI enumeratedNovember 21, 2006
Last updated in NPPESMay 12, 2017
Mailing address415 Fairview Ave, Ste. 100, Ponca City, OK 74601-1923