MEDICARE: KOBY ANDERSON PA-C

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	363A00000X	Physician Assistant	076350	IA
2	363A00000X	Physician Assistant	2475	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1356739486	OTHER	OK	NPI

General Provider Information

NPI Number	:	1356739486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOBY ANDERSON PA-C

Provider Business Mailing Address
First Line	:	3110 SW 89TH ST STE 200E
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7919
Country	:	US
Telephone Number	:	405-486-6720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3110 SW 89TH ST STE 200E
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7919
Country	:	US
Telephone Number	:	405-486-6720
Fax Number	:

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

Provider Enumeration Date	:	12/23/2014
Last Update Date	:	02/13/2020

Similar Medicare Providers

1265424204 — DR. JEFFREY PAUL NEES MD
Practice Location Address:

3110 SW 89TH ST STE 200E
OKLAHOMA CITY, OK
73159-7919

Practice Phone: 405-486-6720
Practice Fax: 405-286-6485

1336111483 — MR. GRANT D ROBERTS PA
Practice Location Address:

3110 SW 89TH ST STE 102
OKLAHOMA CITY, OK
73159-7919

Practice Phone: 405-703-4950
Practice Fax: 405-703-4955

1114991304 — OKLAHOMA CENTER FOR ORTHOPAEDIC EXCELLENCE & SPORTS MEDICINE, LLC
Practice Location Address:

3110 SW 89TH ST , SUITE 200C
OKLAHOMA CITY, OK
73159-7919

Practice Phone: 405-759-2663
Practice Fax: 405-759-3827

1588010656 — DR. NATHANIEL MONNET ODOR MD
Practice Location Address:

3110 SW 89TH ST STE 200D
OKLAHOMA CITY, OK
73159-7919

Practice Phone: 405-906-4059
Practice Fax:

1942188172 — ANNABETH CHERIE HEINZ
Practice Location Address:

3110 SW 89TH ST STE 102
OKLAHOMA CITY, OK
73159-7919

Practice Phone: 405-703-4950
Practice Fax:

1588630420 — DR. RICKY PAGE M.D.
Practice Location Address:

7919 MID AMERICA BLVD FL 3
OKLAHOMA CITY, OK
73135-6610

Practice Phone: 405-855-6000
Practice Fax:

Directions to “ KOBY ANDERSON PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.