Unknown Individual – Psychiatry Physician, NPI 1770582819

Unknown Individual is a healthcare provider. based in Lawton, Oklahoma. specializing in Psychiatry Physician. They hold a License No. 22011 (OK). The NPI Number for Unknown Individual is 1770582819

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770582819
Phone
(580) 248-5780
Address
602 SW 38TH ST
Deactivation Date
17 November 2022

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
3779562392
Professional Enrollment ID
I20040716001052
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

  • 602, Southwest 38th Street, Lawton, Comanche County, Oklahoma, 73505, United States

    LAWTON, OK 735056912

    Phone: (580) 248-5780

    Fax: (580) 248-3610

    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 73505)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1770582819.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Lawton, Oklahoma in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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