Glenn Lytle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16019 Issued in OK

Practice address

3801 W Utica St
Broken Arrow, OK 74011-1365

Phone

(918) 286-1920

Fax

(918) 286-1920

NPI assigned

Dec 29, 2005

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

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1194702167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W UTICA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740111365",
            "telephone_number": "918-286-1920",
            "fax_number": "918-286-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W UTICA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740111365",
            "telephone_number": "918-286-1920",
            "fax_number": "918-286-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTLE",
        "first_name": "GLENN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hal Luo
• Thuy Luu
• Richard Ly, PHARMD
• Rylie Kathleen Lynch
• Jillian Danielle Marie Lynn
• Frances Macarthur, P.T.
• Lisa Diane Macek, M.D.
• Brittany Macleod, DDS
• Amanda Madden, D.O.
• Alexis Madison

• Family Medicine Physician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.