Healthcare Provider Details

I. General information

NPI: 1669652145
Provider Name (Legal Business Name): PHILIP A. FLOYD, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 NW 63RD ST
OKLAHOMA CITY OK
73116-4839
US

IV. Provider business mailing address

PO BOX 25016
OKLAHOMA CITY OK
73125-0016
US

V. Phone/Fax

Practice location:
  • Phone: 405-286-5557
  • Fax: 405-286-5680
Mailing address:
  • Phone: 405-286-5557
  • Fax: 405-286-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number21042
License Number StateOK

VIII. Authorized Official

Name: DR. PHILIP A. FLOYD
Title or Position: GENERAL SURGEON
Credential: M.D.
Phone: 405-286-5557