MEDICARE: DAVID L KYGER MD PC

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	207R00000X	Internal Medicine Physician	9223	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110236658	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	730929415001	OTHER		BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811972581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID L KYGER MD PC

Provider Business Mailing Address
First Line	:	3332 W OKMULGEE
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401
Country	:	US
Telephone Number	:	918-682-2481
Fax Number	:	918-682-2932

Provider Business Practice Location Address
First Line	:	3332 WEST OKMULGEE STREET
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401
Country	:	US
Telephone Number	:	918-682-2481
Fax Number	:	918-682-2932

Authorized Official
Title or Position	:	PRES
Name	:	DAVID L KYGER
Credential	:	MD
Telephone Number	:	918-682-2481

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	07/29/2014

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Directions to “DAVID L KYGER MD PC ” Practice Location

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