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General NPI Number Information
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NPI Number | 1548762982
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Entity Type | Individual
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Provider Name | MR. LLOYD DEAN HILBURN
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Gender | Male
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 225 N. BROADWAY P.O. BOX 99
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City | CARNEGIE
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State | OK
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Zip | 73015
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Country | US
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Telephone | 580-654-1439
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Fax | 580-654-2637
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Provider Business Mailing Address
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Address Line | 225 N. BROADWAY P.O. BOX 99
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City | CARNEGIE
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State | OK
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Zip | 73015
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Country | US
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Telephone | 580-654-1439
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Fax | 580-654-2637
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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 | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 1195
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License Number State | OK
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