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General NPI Number Information
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NPI Number | 1669467312
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Entity Type | Individual
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Provider Name | PHYLLIS PYRUM ENGLES MD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1802 RADIO RD
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City | DURANT
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State | OK
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Zip | 74701-2006
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Country | US
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Telephone | 580-924-6273
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 818
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City | DURANT
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State | OK
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Zip | 74702-0818
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Country | US
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Telephone | 580-924-6273
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9064
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License Number State | OK
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