Active NPI
John C Loose, D.O.
- Family Medicine Physician
- Lawton, OK
National Provider Identifier
1073693917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3271
- Practice address
- 3201 W Gore Blvd Ste 305
Memorial Medical Group
Lawton, OK 73505-6350 - Phone
- (580) 510-7070
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3271 | OK | Primary |
Addresses
Primary practice location
3201 W Gore Blvd Ste 305
Memorial Medical Group
Lawton, OK 73505-6350
Mailing address
8 NW Wentwood Hill Dr
Lawton, OK 73505-9501
Phone (580) 704-2502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3271 | OK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477526400000",
"number": "1073693917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 NW WENTWOOD HILL DR",
"city": "LAWTON",
"state": "OK",
"postal_code": "735059501",
"telephone_number": "580-704-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 W GORE BLVD STE 305",
"address_2": "MEMORIAL MEDICAL GROUP",
"city": "LAWTON",
"state": "OK",
"postal_code": "735056350",
"telephone_number": "580-510-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOOSE",
"first_name": "JOHN",
"middle_name": "C",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2016-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "3271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.