Unknown Individual – Family Medicine Physician, NPI 1396948154
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
301, Wanda Street, Marietta, Love County, Oklahoma, 73448, United States
MARIETTA, OK 734481229
Phone: (580) 276-2400
Fax: (580) 276-4358
Type: Mailing
South 29th Street, Chickasha, Grady County, Oklahoma, 73018, United States
CHICKASHA, OK 730182501
Phone: (405) 896-8058
Fax: (855) 782-5256
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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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 ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73448)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Psychiatry | OK | |
| Family Practice | OK | |
| Family Practice | OK | |
| Family Practice, Emergency Medicine | TN | |
| - | OK | |
| Family Practice | KS |
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