MEDICARE: PATRICK VANSCHOYCK M.D.

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	207Q00000X	Family Medicine Physician	15344	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	:	1124088083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK VANSCHOYCK M.D.

Provider Business Mailing Address
First Line	:	7912 E 31ST CT
Second Line	:	STE 220
City	:	TULSA
State	:	OK
Zip	:	74145-1315
Country	:	US
Telephone Number	:	918-743-8200
Fax Number	:	918-743-8609

Provider Business Practice Location Address
First Line	:	7912 E 31ST CT
Second Line	:	STE 220
City	:	TULSA
State	:	OK
Zip	:	74145-1315
Country	:	US
Telephone Number	:	918-743-8200
Fax Number	:	918-743-8609

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/25/2023

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