Healthcare Provider Details

I. General information

NPI: 1033059506
Provider Name (Legal Business Name): COLBY R BOYKIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHICKASAW NATION MEDICAL CENTER 1921 STONECIPHER BLVD A
ADA OK
74820
US

IV. Provider business mailing address

324 S GABBERT ST
MONTICELLO AR
71655-4928
US

V. Phone/Fax

Practice location:
  • Phone: 580-436-3980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: