MEDICARE: TONI M MADDOX APRN

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	363LF0000X	Family Nurse Practitioner	215161	OK

General Provider Information

NPI Number	:	1578341210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI M MADDOX APRN

Provider Business Mailing Address
First Line	:	1232 SW 89TH ST STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9110
Country	:	US
Telephone Number	:	888-495-2138
Fax Number	:	405-421-0916

Provider Business Practice Location Address
First Line	:	1232 SW 89TH ST STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9110
Country	:	US
Telephone Number	:	888-495-2138
Fax Number	:	405-421-0916

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

Provider Enumeration Date	:	09/14/2023
Last Update Date	:	08/14/2025

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Directions to “ TONI M MADDOX APRN” Practice Location

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