MEDICARE: BETTY HARMON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	17592	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124017934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY HARMON MD

Provider Business Mailing Address
First Line	:	1200 MAGNOLIA CT ST 102
Second Line	:	STE 102
City	:	MOORE
State	:	OK
Zip	:	73160
Country	:	US
Telephone Number	:	405-650-5470
Fax Number	:	405-261-9266

Provider Business Practice Location Address
First Line	:	1200 MAGNOLIA CT ST 102
Second Line	:	STE 102
City	:	MOORE
State	:	OK
Zip	:	73160
Country	:	US
Telephone Number	:	405-912-3100
Fax Number	:	405-912-3104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	04/15/2026

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Directions to “ BETTY HARMON MD” Practice Location

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