Healthcare Provider Details

I. General information

NPI: 1649891979
Provider Name (Legal Business Name): PAYTON ROLLINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2557 OLD TIMBERS DR
EDMOND OK
73034-9813
US

IV. Provider business mailing address

3001 QUAIL SPRINGS PKWY FL 5
OKLAHOMA CITY OK
73134-2640
US

V. Phone/Fax

Practice location:
  • Phone: 405-669-2600
  • Fax: 405-500-1232
Mailing address:
  • Phone: 405-669-2600
  • Fax: 405-500-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41506
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: