Adel George Kyrollos, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21108 Issued in OK

Practice address

Ccom Medical Group, Inc.
350 S. 40TH Street
Muskogee, OK 74401

Phone

(918) 683-0753

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053348094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CCOM MEDICAL GROUP, INC.",
            "address_2": "350 S. 40TH STREET",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-683-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CCOM MEDICAL GROUP, INC.",
            "address_2": "350 S. 40TH STREET",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-683-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYROLLOS",
        "first_name": "ADEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "21108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "21108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Nmi Kunzelman, PT
• Ken Kuykendall, M.D.
• Sara Kuykendall
• David L Kyger, M.D.
• Sophia Kyle
• Mark K Labhart, RPT
• Haley Labor
• Rea Lynn Lake
• Dharshan K Lakshminarayan, M.D.
• Gary William Lambert, DO

• Internal Medicine Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.