Psydoc LLC

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

Legal business name

PSYDOC LLC

Practice address

309 N Redbud Ave
Broken Arrow, OK 74012-2376

Phone

(918) 813-7682

NPI assigned

Mar 16, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen Patton, MD

Title

MD, Owner

Phone

(918) 813-7682

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1003209057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1325",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740131325",
            "telephone_number": "918-813-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N REDBUD AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122376",
            "telephone_number": "918-813-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYDOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "MD, OWNER",
        "authorized_official_telephone_number": "918-813-7682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.