University of Oklahoma Health Scien Ctr Southwest Ok Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

UNIVERSITY OF OKLAHOMA HEALTH SCIEN CTR SOUTHWEST OK FAMILY PRACTICE

Practice address

1202 NW Arlington Ave
Lawton, OK 73507-6537

Phone

(580) 248-2288

Fax

(580) 248-5757

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brian Maddy

Title

Chief Executive Officer

Phone

(405) 271-3932

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwest Oklahoma Family Practice Doing business as

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emilie Charlene Fallwell, NP-C

  • Family Nurse Practitioner
  • Lawton, OK
  • NPI 1629365713
  NPD (past)
• David Allen Hanley, MD

  • Anesthesiology Physician
  • Lawton, OK
  • NPI 1083830715
  NPD (past)
• Kimberly Noelle Hanley, APRN, NP-C

  • Family Nurse Practitioner
  • Lawton, OK
  • NPI 1801414628
  NPD (past)
• Roger D Hanley, CRNA

  • Certified Registered Nurse Anesthetist
  • Lawton, OK
  • NPI 1588656235
  NPD (past)
• Mikayla Neal Mefford, PA-C

  • Physician Assistant
  • Lawton, OK
  • NPI 1245830439
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1790893097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 NW ARLINGTON AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735076537",
            "telephone_number": "580-248-2288",
            "fax_number": "580-248-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 NW ARLINGTON AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735076537",
            "telephone_number": "580-248-2288",
            "fax_number": "580-248-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF OKLAHOMA HEALTH SCIEN CTR SOUTHWEST OK FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "MADDY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "405-271-3932",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021490C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Oklahoma Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Merita Tyrell-Mitchell, LMFT
• U.S. Medical LLC
• Lindsi Diane Ulloa
• Ultimate Fit Chiropractic PLLC
• Kayla Michelle Underwood
• Priyanka Nagasri Upadrasta, MD
• US Army
• Mark Vincent Vadney, CRNA
• Lily Sky Vail
• Valir Outpatient Clinic #16 LLC

• All providers in Lawton, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.