Healthcare Provider Details

I. General information

NPI: 1508609835
Provider Name (Legal Business Name): KMF MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NW 72ND ST STE 245
WARR ACRES OK
73132-5948
US

IV. Provider business mailing address

5601 NW 72ND ST STE 245
WARR ACRES OK
73132-5948
US

V. Phone/Fax

Practice location:
  • Phone: 918-417-0878
  • Fax:
Mailing address:
  • Phone: 918-417-0878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER FISHER
Title or Position: OWNER
Credential: MD
Phone: 918-417-0878