Unknown Individual – Anesthesiology Physician, NPI 1487744504

Unknown Individual is a healthcare provider. based in Enid, Oklahoma. specializing in Anesthesiology Physician. They hold a License No. 2665 (OK). The NPI Number for Unknown Individual is 1487744504

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487744504
Phone
(580) 233-7171
Address
1133 WEST WILLOW RD
Deactivation Date
8 November 2024

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
5802337171
Graduation Year
1981 (45 years ago)
PAC ID
9032286471
Group Practice PAC ID
6002082567
Professional Enrollment ID
I20080926000087
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

  • 1133, West Willow Road, Enid, Garfield County, Oklahoma, 73703, United States

    ENID, OK 73703

    Phone: (580) 233-7171

    Fax: (580) 233-6680

    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 73703)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002082567View full group profile
NameSpecialtyState
-OK
Certified Registered Nurse Anesthetist (Crna)AR
A N E S T H E S I O L O G YOK

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1487744504 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Anesthesiology Physician. 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.
What if Enid, Oklahoma seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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