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NPI Code Detail

MEDICARE: DR. JOHN R PITTMAN M.D.

MEDICARE: DR. JOHN R PITTMAN M.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
1207Q00000XFamily Medicine Physician13230OK

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 : 1588646988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R PITTMAN M.D.
Provider Business Mailing Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Provider Business Practice Location Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-722-9474
Fax Number : 405-722-9463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2005
Last Update Date : 11/30/2015

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Directions to “ DR. JOHN R PITTMAN M.D.” Practice Location

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