Unknown Individual – Physician Assistant, NPI 1871558064
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
255 BEAVER ACADEMY RD
ARDMORE, OK 734017516
Phone: (580) 226-0906
Type: Mailing
1001, 15th Avenue Northwest, Ardmore, Carter County, Oklahoma, 73401, United States
SUITE A
ARDMORE, OK 734011810
Phone: (580) 223-2123
Fax: (580) 490-9228
Type: Location
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)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73401)
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