Active NPI
Steven Randolph Matlock, DPH
- Pharmacist
- Midwest City, OK
National Provider Identifier
1821101627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9146
- Practice address
- 7128 East Reno Avenue
Suite a
Midwest City, OK 73110 - Phone
- (405) 737-3464
- Fax
- (405) 737-9554
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9146 | OK | Primary |
Addresses
Primary practice location
7128 East Reno Avenue
Suite a
Midwest City, OK 73110
Mailing address
12008 Rivendell Drive
Oklahoma City, OK 73170
Phone (405) 691-7270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9146 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Wilson Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Midwest City, OK
- NPI 1669576625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821101627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12008 RIVENDELL DRIVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73170",
"telephone_number": "405-691-7270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7128 EAST RENO AVENUE",
"address_2": "SUITE A",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "73110",
"telephone_number": "405-737-3464",
"fax_number": "405-737-9554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOCK",
"first_name": "STEVEN",
"middle_name": "RANDOLPH",
"credential": "DPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "9146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midwest City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.