NPIMap

Individual provider Active NPI

Harrell Douglas Proctor, M.D.

  • Family Medicine Physician
  • Duncan, OK
National Provider Identifier
1467454769
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
10568 Issued in OK
Practice address
2515 W Elk Ave
Duncan, OK 73533-1571
Phone
(580) 252-6080
Fax
(580) 470-2933
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10568 OK Primary

Addresses

Primary practice location

2515 W Elk Ave
Duncan, OK 73533-1571

Mailing address

2515 W Elk Ave
Duncan, OK 73533-1571
Phone (580) 252-6080

Other identifiers 1

IdentifierTypeStateIssuer
100105130CMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110628000904 OK Practitioner - Family Practice 7416913330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duncan Regional Hospital, IncGroup PAC ID 5193613057, 69 clinicians

Practice addresses (Care Compare)

1415 N Whisenant Dr
Duncan, OK 73533-1650
Phone (580) 252-5300

2150 W Elk Ave
Duncan, OK 73533-1827
Phone (580) 251-6657

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue503
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10568OKMDClinical Pharmacology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duncan Regional Hospital, Inc Family Medicine CurrentSince Jul 5, 2023 Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Duncan Regional Hospital, Inc Family Medicine Past Accepting new patients

Locations

2515 W Elk Ave
Duncan, OK 73533
Phone (580) 252-6080

2515 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-6806

Organizations & group practices 4

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

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1467454769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 W ELK AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331571",
            "telephone_number": "580-252-6080",
            "fax_number": "580-470-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W ELK AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331571",
            "telephone_number": "580-252-6080",
            "fax_number": "580-470-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "HARRELL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "10568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100105130C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.