Daryl E Birdwell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10548OK Issued in OK

Practice address

4417 W Gore Blvd
Suite 2
Lawton, OK 73505-5978

Phone

(580) 248-7417

Fax

(580) 248-4847

NPI assigned

Aug 25, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Daryl E. Birdwell, M.D., Inc.

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1972631067
  NPD
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639287378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 W GORE BLVD",
            "address_2": "SUITE 2",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055978",
            "telephone_number": "580-248-7417",
            "fax_number": "580-248-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 W GORE BLVD",
            "address_2": "SUITE 2",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055978",
            "telephone_number": "580-248-7417",
            "fax_number": "580-248-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDWELL",
        "first_name": "DARYL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "10548OK",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "10548OK",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian John Bigelow, PH.D., ABPP
• Shannon Bighair
• Karen T. Bill
• Tanisha Billingslea, PH.D
• Brian Gillam Birdwell, M.D.
• Bette J. Bischoff Glidewell, MD
• Laura Bishop
• Marquise Lushuan Bishop, BS
• Kelli Bissell
• Robin Bitseedy, LPN

• Family Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.