MEDICARE: DR. DAVID RANDALL DESCHAMPS 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	207V00000X	Obstetrics & Gynecology Physician	E11038	AR
2	207V00000X	Obstetrics & Gynecology Physician	27776	OK
3	207VM0101X	Maternal & Fetal Medicine Physician	27776	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700107869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RANDALL DESCHAMPS M.D.

Provider Business Mailing Address
First Line	:	4140 W MEMORIAL RD STE 321
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8300
Country	:	US
Telephone Number	:	405-748-4726
Fax Number	:	405-607-8761

Provider Business Practice Location Address
First Line	:	5414 W PINNACLE POINTE DR STE 300
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8956
Country	:	US
Telephone Number	:	479-268-4998
Fax Number	:	479-268-4979

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

Provider Enumeration Date	:	06/11/2010
Last Update Date	:	01/07/2020

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Directions to “ DR. DAVID RANDALL DESCHAMPS M.D.” Practice Location

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