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1043218381

NPI Code Detail

MEDICARE: PAUL ALAN KAMMERLOCHER MD

MEDICARE: PAUL ALAN KAMMERLOCHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	17277	OK
2	207X00000X	Orthopaedic Surgery Physician	17277	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043218381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ALAN KAMMERLOCHER MD

Provider Business Mailing Address
First Line	:	9600 BROADWAY EXT
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-7408
Country	:	US
Telephone Number	:	405-230-9000
Fax Number	:	405-230-9157

Provider Business Practice Location Address
First Line	:	3115 SW 89TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7901
Country	:	US
Telephone Number	:	405-486-6900
Fax Number	:	405-486-6839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	04/05/2023

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Directions to “ PAUL ALAN KAMMERLOCHER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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