Morgan A Seubold, DC

Individual provider Active NPI Chiropractor · Roland, OK

NPI 1174604268 · NPPES record last updated Nov 9, 2007

Key facts

NPI
1174604268
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
20060642 (OK)
Practice address
1022 E Ray Fine Blvd
Ste 4
Roland, OK 74954
Phone
(918) 427-3630
Fax
(918) 427-3681
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1022 Ray Fine Blvd
Suite 4
Roland, OK 74954
Phone (918) 427-3630

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060110001056 OK Practitioner - Chiropractic 4880616408 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
20060642OKMDChiropractor
3745OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Seubold Family Chiropractic Inc Chiropractor Current
since Oct 18, 2005
Accepting new patients

Locations

307 E Ray Fine Blvd
Unit 2
Roland, OK 74954

307 E Ray Fine Blvd
Ste 2
Roland, OK 74954

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 20060642 OK Yes

Addresses

Primary practice location

1022 E Ray Fine Blvd
Ste 4
Roland, OK 74954

Mailing address

PO Box 924
Roland, OK 74954-0924
Phone (918) 427-3630

Other providers in Roland, OK

All providers in Roland, OK · Chiropractor in Oklahoma

Sources for this page

Verify at the official NPI Registry.