Healthcare Provider Details
I. General information
NPI: 1811092042
Provider Name (Legal Business Name): ERIN PALMER NEWELL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/13/2006
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
723 S MAIN ST
KINGFISHER OK
73750-3622
US
IV. Provider business mailing address
723 S MAIN ST
KINGFISHER OK
73750-3622
US
V. Phone/Fax
- Phone: 405-375-5497
- Fax: 405-375-5485
- Phone: 405-375-5497
- Fax: 405-375-5485
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3790 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: