Healthcare Provider Details

I. General information

NPI: 1659714772
Provider Name (Legal Business Name): ROBERT HAROLD CORTNER JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 NE 15TH ST
GUYMON OK
73942-3317
US

IV. Provider business mailing address

501 NE 15TH ST
GUYMON OK
73942-3317
US

V. Phone/Fax

Practice location:
  • Phone: 580-338-4638
  • Fax: 580-338-4642
Mailing address:
  • Phone: 580-338-4638
  • Fax: 580-338-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5470
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5470
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: