Healthcare Provider Details

I. General information

NPI: 1144414608
Provider Name (Legal Business Name): CURTIS SCHENK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N CLARENCE NASH
WATONGA OK
73772-3636
US

IV. Provider business mailing address

PO BOX 669
WATONGA OK
73772-3636
US

V. Phone/Fax

Practice location:
  • Phone: 580-623-4954
  • Fax: 580-623-4954
Mailing address:
  • Phone: 580-623-4954
  • Fax: 580-623-4980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10664
License Number StateOK

VIII. Authorized Official

Name: DR. CURTIS ANDREW SCHENK
Title or Position: OWNER
Credential: MD
Phone: 580-623-4954