Unknown Individual – Family Medicine Physician, NPI 1265423156
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
100, Bliss Avenue, Tahlequah, Cherokee County, Oklahoma, 74464, United States
TAHLEQUAH, OK 744642512
Phone: (918) 458-3368
Fax: (918) 458-3657
Type: Location
508, Greenwood Drive, Tahlequah, Cherokee County, Oklahoma, 74464, United States
TAHLEQUAH, OK 744645141
Phone: (918) 458-3368
Fax: (918) 458-3657
Type: Mailing
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 74464)
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