Mark Kirkpatrick Jr.
Individual provider Active NPI Behavior Analyst · Ada, OK
NPI 1073962080 · NPPES record last updated Jun 9, 2016
Key facts
- NPI
- 1073962080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 921 E 14TH St
Ada, OK 74820 - Phone
- (661) 644-9009
- NPI assigned
- Jun 9, 2016
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
921 E 14TH St
Ada, OK 74820
Mailing address
921 E 14TH St
Ada, OK 74820-6817
Phone (661) 644-9009
Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2016. 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.