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1972802254

NPI Code Detail

MEDICARE: ERIC MICHAEL CANADAY D.O.

MEDICARE: ERIC MICHAEL CANADAY D.O.

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	5535	OK
2	207Q00000X	Family Medicine Physician	E-13441	AR
3	207P00000X	Emergency Medicine Physician	5535	OK
4	207P00000X	Emergency Medicine Physician	2011020294	MO
5	207P00000X	Emergency Medicine Physician	E-13441	AR
6	207Q00000X	Family Medicine Physician	05-51964	KS
7	207Q00000X	Family Medicine Physician	2025044563	MO
8	207Q00000X	Family Medicine Physician	W1394	TX

General Provider Information

NPI Number	:	1972802254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC MICHAEL CANADAY D.O.

Provider Business Mailing Address
First Line	:	7536 N 200TH EAST AVE
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-8217
Country	:	US
Telephone Number	:	918-853-4916
Fax Number	:

Provider Business Practice Location Address
First Line	:	2488 E 81ST ST STE 2000
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-4224
Country	:	US
Telephone Number	:	918-592-9020
Fax Number	:

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

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	11/03/2025

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Directions to “ ERIC MICHAEL CANADAY D.O.” 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.

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