Medical Director Services Oklahoma LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDICAL DIRECTOR SERVICES OKLAHOMA LLC

Practice address

1622 E Broadway St # Ok74403
Muskogee, OK 74403-4601

Phone

(718) 931-9700

NPI assigned

Sep 16, 2026

Organization subpart

No

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

Authorized official

Name

Samuel Kohn

Title

Manager

Phone

(347) 631-6775

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1619888567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 E BROADWAY ST # OK74403",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034601",
            "telephone_number": "718-931-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIRECTOR SERVICES OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-631-6775"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.