James Andrew Macrobert, DDS

Individual provider Active NPI General Practice Dentistry · Mangum, OK

NPI 1649280710 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1649280710
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2808 (OK)
Practice address
230 E Jefferson St
Mangum, OK 73554-4202
Phone
(580) 782-2552
Fax
(580) 782-9266
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2808OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shortgrass Community Health Center, Inc Past Accepting new patients
Ez Sleep Solutions, Inc. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2808 OK Yes

Addresses

Primary practice location

230 E Jefferson St
Mangum, OK 73554-4202

Mailing address

110 W Harrison St
Mangum, OK 73554-3002
Phone (580) 782-2552

Other providers in Mangum, OK

All providers in Mangum, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.