Unknown Individual – Chiropractor, NPI 1063493450

Unknown Individual is a healthcare provider. based in Enid, Oklahoma. specializing in Chiropractor. They hold a License No. 1513 (OK). The NPI Number for Unknown Individual is 1063493450

Main info

Organization
Inactive
65 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063493450
Phone
(580) 233-7500
Address
721 W BROADWAY AVE
Deactivation Date
28 January 2022

Doctor Profile

Medical School Name
PALMER COLLEGE CHIROPRACTIC - DAVENPORT
Secondary Phone
5802337500
Graduation Year
1961 (65 years ago)
PAC ID
8729112636
Professional Enrollment ID
I20100813000881
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 721, West Broadway Avenue, Enid, Garfield County, Oklahoma, 73701, United States

    STE A

    ENID, OK 737013800

    Phone: (580) 233-7500

    Fax: (580) 233-7501

    Type: Location

  • 3020, Hillcrest Drive, Enid, Garfield County, Oklahoma, 73701, United States

    ENID, OK 737017783

    Phone: (580) 234-8016

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73701)

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Provider's Procedures

Unknown Individual performs procedures in Chiropractor. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CHIROPRACTICOK98940Chiropractic manipulative treatment, 1-2 spinal regions21724

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1063493450 if you need a stable reference for Unknown Individual.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Chiropractor for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Oklahoma?
You will see Enid, Oklahoma on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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