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NPI Code Detail

MEDICARE: KRISTIN F EARLEY D.O.

MEDICARE:   KRISTIN F EARLEY  D.O.
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
1207Q00000XFamily Medicine Physician39874SC
2207Q00000XFamily Medicine Physician4068OK

Other Identifiers

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

General Provider Information

NPI Number : 1306886106
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN F EARLEY D.O.
Provider Business Mailing Address
First Line : 6801 W MEMORIAL RD UNIT E
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2103
Country : US
Telephone Number : 405-491-4090
Fax Number : 405-491-4091
Provider Business Practice Location Address
First Line : 5201 W MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2004
Country : US
Telephone Number : 405-755-4050
Fax Number : 405-749-9566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 04/17/2025

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Directions to “ KRISTIN F EARLEY D.O.” Practice Location

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