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NPI Code Detail

MEDICARE: DR. KIMBERLEY K PITTMAN PSY.D.

MEDICARE: DR. KIMBERLEY K PITTMAN PSY.D.
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
1103TC0700XClinical Psychologist1111OK
2103T00000XPsychologist1111OK

General Provider Information

NPI Number : 1427257617
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLEY K PITTMAN PSY.D.
Provider Business Mailing Address
First Line : 3035 NW 63RD ST STE 227
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3631
Country : US
Telephone Number : 405-849-6173
Fax Number : 405-544-5916
Provider Business Practice Location Address
First Line : 3035 NW 63RD ST STE 227
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3631
Country : US
Telephone Number : 405-849-6173
Fax Number : 405-544-5916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2007
Last Update Date : 11/06/2024

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