Healthcare Provider Details

I. General information

NPI: 1295672202
Provider Name (Legal Business Name): KYLA GROVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 W 6TH AVE
STILLWATER OK
74074-4399
US

IV. Provider business mailing address

1029 E VANDAMENT AVE
YUKON OK
73099-4949
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-1480
  • Fax:
Mailing address:
  • Phone: 405-350-4300
  • Fax: 405-350-4302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: