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General NPI Number Information
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NPI Number | 1467128371
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Entity Type | Individual
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Provider Name | MR. BOB J MAGAR
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Gender | Male
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 228 ROBERT S KERR AVE STE 715
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-5206
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Country | US
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Telephone | 405-921-0560
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Fax | 405-228-2525
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Provider Business Mailing Address
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Address Line | 1908 OAK DR
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City | MOORE
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State | OK
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Zip | 73170-7904
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Country | US
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Telephone | 405-921-0560
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Fax | 405-228-2525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 352
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1420
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1420
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License Number State | OK
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