Dustin Rose

Individual provider Active NPI Peer Specialist · Lexington, OK

NPI 1003572124 · NPPES record last updated Nov 12, 2021

Key facts

NPI
1003572124
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
104 Owens St
Lexington, OK 73051-9572
Phone
(405) 837-5821
NPI assigned
Nov 12, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

104 Owens St
Lexington, OK 73051-9572

Mailing address

104 Owens St
Lexington, OK 73051-9572

Other providers in Lexington, OK

All providers in Lexington, OK · Peer Specialist in Oklahoma

Sources for this page

Verify at the official NPI Registry.