Active NPI
Michael D David DO
- Family Medicine Physician
- Grove, OK
National Provider Identifier
1376624361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3714
- Legal business name
- MICHAEL D DAVID DO
- Practice address
- 4602 Highway 59 N
Grove, OK 74344-4229 - Phone
- (918) 786-5026
- Fax
- (918) 786-5141
- NPI assigned
- Oct 18, 2006
- Last updated
- May 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael D David, DO
- Title
- Owner
- Phone
- (918) 786-5026
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3714 | OK | Primary |
Addresses
Primary practice location
4602 Highway 59 N
Grove, OK 74344-4229
Mailing address
PO Box 451087
Grove, OK 74345-1087
Phone (918) 786-5026
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CJ6320 | Other | OK | RAILROAD MEDICARE GROUP # |
| 100723280A | Medicaid | OK |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nurse Practitioner
- Grove, OK
- NPI 1912905878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210118400000",
"number": "1376624361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 451087",
"city": "GROVE",
"state": "OK",
"postal_code": "743451087",
"telephone_number": "918-786-5026",
"fax_number": "918-786-5141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4602 HIGHWAY 59 N",
"city": "GROVE",
"state": "OK",
"postal_code": "743444229",
"telephone_number": "918-786-5026",
"fax_number": "918-786-5141"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHAEL D DAVID DO",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-18",
"last_updated": "2008-05-07",
"status": "A",
"authorized_official_last_name": "DAVID",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-786-5026",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "OK",
"license": "3714",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP #",
"identifier": "CJ6320",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100723280A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grove, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.