David Ewing
Individual provider Active NPI Peer Specialist · Glenpool, OK
NPI 1497315667 · NPPES record last updated Jun 19, 2019
Key facts
- NPI
- 1497315667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 596 E 147TH St S
Glenpool, OK 74033-3926 - Phone
- (496) 586-7524
- NPI assigned
- Jun 19, 2019
- 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
596 E 147TH St S
Glenpool, OK 74033-3926
Mailing address
596 E 147TH St S
Glenpool, OK 74033-3926
Other providers in Glenpool, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2019. 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.