Unknown Individual – Cardiovascular Disease Physician, NPI 1770515009

Unknown Individual is a healthcare provider. based in Muskogee, Oklahoma. specializing in Cardiovascular Disease Physician. They hold a License No. 23376 (OK). The NPI Number for Unknown Individual is 1770515009

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770515009
Phone
(918) 683-0753
Address
350 S 40TH ST
Deactivation Date
30 January 2025
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

  • 350, South 40th Street, Muskogee, Muskogee County, Oklahoma, 74401, United States

    MUSKOGEE, OK 744014915

    Phone: (918) 683-0753

    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.

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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 74401)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1770515009 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Muskogee, Oklahoma.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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