Healthcare Provider Details

I. General information

NPI: 1174468680
Provider Name (Legal Business Name): DAKOTA RAY FORBES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 721 MACOMB ROAD
FORT SILL OK
73503
US

IV. Provider business mailing address

BUILDING 721 MACOMB ROAD
FORT SILL OK
73503
US

V. Phone/Fax

Practice location:
  • Phone: 580-442-4689
  • Fax: 580-442-3114
Mailing address:
  • Phone: 580-442-4689
  • Fax: 580-442-3114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6520
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: