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NPI Code Detail

MEDICARE: REBECCA A. FELICIANO, M.D., INC

MEDICARE: REBECCA A. FELICIANO, M.D., INC
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
12084P0800XPsychiatry Physician13421OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2546478285002OTHEROKBCBS OF OKLAHOMA

General Provider Information

NPI Number : 1962579334
Entity Type Code : Organization
Provider Name (Legal Business Name) : REBECCA A. FELICIANO, M.D., INC
Provider Business Mailing Address
First Line : PO BOX 12883
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73157-2883
Country : US
Telephone Number : 405-858-0600
Fax Number : 404-858-0602
Provider Business Practice Location Address
First Line : 2129 SW 59TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73119-7024
Country : US
Telephone Number : 405-272-6216
Fax Number : 405-272-6927
Authorized Official
Title or Position : PRESIDENT
Name : DR. REBECCA A. FELICIANO
Credential : M.D.
Telephone Number : 405-503-3107
Provider Enumeration Date : 11/29/2006
Last Update Date : 08/21/2014

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