Healthcare Provider Details

I. General information

NPI: 1730098740
Provider Name (Legal Business Name): BEN TALBOT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3149 N HIGHWAY 81
DUNCAN OK
73533-9283
US

IV. Provider business mailing address

3149 N HIGHWAY 81
DUNCAN OK
73533-9283
US

V. Phone/Fax

Practice location:
  • Phone: 580-359-0596
  • Fax: 580-359-0640
Mailing address:
  • Phone: 580-359-0596
  • Fax: 580-359-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number3026
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: