MEDICARE: KMF MEDICAL GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BN1400X	Nursing Facility Supplies (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BD1200X	Dialysis Equipment & Supplies (DME)
4	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1508609835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMF MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1501 NW 174TH CT
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73012-9713
Country	:	US
Telephone Number	:	918-417-0878
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 NW 72ND ST STE 245
Second Line	:
City	:	WARR ACRES
State	:	OK
Zip	:	73132-5948
Country	:	US
Telephone Number	:	918-417-0878
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER FISHER
Credential	:	MD
Telephone Number	:	918-417-0878

Provider Enumeration Date	:	06/14/2024
Last Update Date	:	08/22/2025

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