John Waldron
Individual provider Active NPI Peer Specialist · Beggs, OK
NPI 1417580465 · NPPES record last updated Feb 18, 2020
Key facts
- NPI
- 1417580465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 3815 Highway 75
Beggs, OK 74421-2367 - Phone
- (918) 845-1076
- NPI assigned
- Feb 18, 2020
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
3815 Highway 75
Beggs, OK 74421-2367
Mailing address
3815 Highway 75
Beggs, OK 74421-2367
Phone (918) 845-1076
Other providers in Beggs, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2020. 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.