Unknown Individual – Family Medicine Physician, NPI 1376605105

Unknown Individual is a healthcare provider. based in Clinton, Oklahoma. specializing in Family Medicine Physician. They hold a License No. 2030 (OK). The NPI Number for Unknown Individual is 1376605105

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1376605105
Phone
(580) 323-2884
Address
RR 1 BOX 3060
Deactivation Date
18 February 2022
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

Provider Addresses for Unknown Individual

  • RR 1 BOX 3060

    CLINTON, OK 736019303

    Phone: (580) 323-2884

    Fax: (580) 323-2579

    Type: Location

  • 1000, North Bowman Avenue, Elk City, Beckham County, Oklahoma, 73644, United States

    ELK CITY, OK 736442219

    Phone: (580) 323-2884

    Fax: (580) 323-2579

    Type: Mailing

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.

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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 73601)

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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 1376605105.
What should I verify if Unknown Individual is listed inactive?
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.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Clinton, Oklahoma in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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