Healthcare Provider Details

I. General information

NPI: 1760048045
Provider Name (Legal Business Name): MICHAEL HARVEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 HEALTH CENTER PARKWAY BLDG 100
YUKON OK
73099
US

IV. Provider business mailing address

1121 NW 63RD ST
NICHOLS HILLS OK
73116-6504
US

V. Phone/Fax

Practice location:
  • Phone: 405-577-6473
  • Fax: 405-577-6474
Mailing address:
  • Phone: 405-652-0632
  • Fax: 405-652-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39725
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: