Kamron Manouchehr Fakhrshafaei
Individual provider Active NPI Case Manager/Care Coordinator · Thomas, OK
NPI 1053010488 · NPPES record last updated Feb 24, 2023
Key facts
- NPI
- 1053010488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 120 W. Broadway
Thomas, OK 73669 - Phone
- (580) 661-3488
- Fax
- (580) 661-3488
- NPI assigned
- Feb 24, 2023
- Sex
- Male
- Sole proprietor
- No
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
120 W. Broadway
Thomas, OK 73669
Mailing address
11520 Cedar Valley Dr
Oklahoma City, OK 73170
Phone (405) 761-5575
Other providers in Thomas, OK
- Lisa Cole
- Kaleb Covey
- Carissa Dobrinski
- Addison Dolan
- Georgia K Duff
- Caitlyn Lenecia Gilbert
- Katrina Annette Gillham
- Dixie Lauren Gunselman
- Harmony Healthcare Center
- Mackenzie Lyn Haverfield
All providers in Thomas, OK · Case Manager/Care Coordinator in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.