MEDICARE: RUSTY SCOTT VOIGHT MPT

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	225100000X	Physical Therapist	4216	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	:	1366857641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSTY SCOTT VOIGHT MPT

Provider Business Mailing Address
First Line	:	509 S 30TH ST
Second Line	:
City	:	CLINTON
State	:	OK
Zip	:	73601-3632
Country	:	US
Telephone Number	:	580-323-8778
Fax Number	:	580-323-8743

Provider Business Practice Location Address
First Line	:	509 S 30TH ST
Second Line	:
City	:	CLINTON
State	:	OK
Zip	:	73601-3632
Country	:	US
Telephone Number	:	580-323-8778
Fax Number	:	580-323-8743

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

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	04/15/2025

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