Unknown Individual – Family Medicine Physician, NPI 1306886031

Unknown Individual is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Family Medicine Physician. They hold a License No. 3557 (OK). The NPI Number for Unknown Individual is 1306886031

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306886031
Phone
(405) 632-1002
Address
7100 S I 35 SERVICE RD
Deactivation Date
22 February 2023

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
4054555330
Graduation Year
1997 (29 years ago)
PAC ID
7315981164
Group Practice PAC ID
2163851478
Professional Enrollment ID
I20050614000101
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

  • South I-35 Service Road, Oklahoma City, Oklahoma County, Oklahoma, 73129, United States

    SUITE 7

    OKLAHOMA CITY, OK 731492740

    Phone: (405) 632-1002

    Fax: (405) 632-3131

    Mailing address matches the actual address.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 73149)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1306886031.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Oklahoma City, Oklahoma?
For routing, start with Oklahoma City, Oklahoma for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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