Healthcare Provider Details

I. General information

NPI: 1447922703
Provider Name (Legal Business Name): HILLARY MARIE PATOCKA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 S 30TH ST
ENID OK
73701-6455
US

IV. Provider business mailing address

231 S 30TH ST
ENID OK
73701-6455
US

V. Phone/Fax

Practice location:
  • Phone: 580-402-5427
  • Fax:
Mailing address:
  • Phone: 580-233-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8632
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: