Healthcare Provider Details

I. General information

NPI: 1063718674
Provider Name (Legal Business Name): OKLAHOMA FOOT AND ANKLE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S TELEPHONE ROAD SUITE B
MOORE OK
73160-5424
US

IV. Provider business mailing address

600 W 15TH ST
EDMOND OK
73013-3617
US

V. Phone/Fax

Practice location:
  • Phone: 405-340-9251
  • Fax: 405-340-0686
Mailing address:
  • Phone: 405-340-9251
  • Fax: 405-340-0686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE J DOWDY
Title or Position: ACCOUNTS MANAGER
Credential:
Phone: 405-794-6691