Active NPI
Robert C Balogh, MD
- Internal Medicine Physician
- Lawton, OK
National Provider Identifier
1265460646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25362
- Practice address
- 3401 W Gore
Lawton, OK 73505 - Phone
- (580) 510-7037
- Fax
- (580) 510-7038
- NPI assigned
- Jun 28, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 45039 | GA | |
| Internal Medicine Physician | 207R00000X | 102704 | MN | |
| Internal Medicine Physician | 207R00000X | 25362 | OK | Primary |
Addresses
Primary practice location
3401 W Gore
Lawton, OK 73505
Mailing address
PO Box 785
Lawton, OK 73502
Phone (580) 357-9984
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 247707803 | Other | OK | MEDICARE ID |
| 200103050A | Medicaid | OK |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45039 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Physicians Group Hospitalists, LLC | Internal Medicine | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Marietta, GA
- NPI 1629025754
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1265460646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 785",
"city": "LAWTON",
"state": "OK",
"postal_code": "73502",
"telephone_number": "580-357-9984",
"fax_number": "580-357-3277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 W GORE",
"city": "LAWTON",
"state": "OK",
"postal_code": "73505",
"telephone_number": "580-510-7037",
"fax_number": "580-510-7038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALOGH",
"first_name": "ROBERT",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "45039",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "102704",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OK",
"license": "25362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "247707803",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200103050A",
"state": "OK"
}
],
"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 Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.