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General NPI Number Information
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NPI Number | 1518243096
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Entity Type | Organization
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Legal Business Name | MAGDALENA B SIKORA MD PC
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 4417 W GORE BLVD SUITE 1
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City | LAWTON
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State | OK
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Zip | 73505-5978
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Country | US
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Telephone | 580-699-5400
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Fax | 580-699-5405
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Provider Business Mailing Address
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Address Line | 1711 SW HASTY WAY
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City | LAWTON
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State | OK
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Zip | 73505-8505
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Country | US
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Telephone | 801-833-6878
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAGDALENA BARBARA SIKORA
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Credential | MD
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Telephone | 801-833-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 28703
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License Number State | OK
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