Lawton Psychiatry Services, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LAWTON PSYCHIATRY SERVICES, LLC

Practice address

605 W Gore Blvd Ste 1
Lawton, OK 73501-3732

Phone

(580) 357-7332

Fax

(580) 357-7455

NPI assigned

Jul 6, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Tammie Blackburn

Title

Medical Billing

Phone

(580) 357-3034

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1861789331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W GORE BLVD STE 1",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013732",
            "telephone_number": "580-357-7332",
            "fax_number": "580-357-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W GORE BLVD STE 1",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735013732",
            "telephone_number": "580-357-7332",
            "fax_number": "580-357-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWTON PSYCHIATRY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_title_or_position": "MEDICAL BILLING",
        "authorized_official_telephone_number": "580-357-3034",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331430A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100205610B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lawton, OK
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.