Organization Active NPI

Phillip Doerner Jr MD PC

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1871765065
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHILLIP DOERNER JR MD PC
Practice address
3100 SW 89TH St
Oklahoma City, OK 73159-7900
Phone
(405) 602-8100
NPI assigned
Mar 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Phillip Doerner, MD
Title
Owner
Phone
(405) 602-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

3100 SW 89TH St
Oklahoma City, OK 73159-7900

Mailing address

PO Box 1547
Sedalia, MO 65302-1547
Phone (660) 826-5960

Other identifiers 2

IdentifierTypeStateIssuer
100827590CMedicaidOK
DF2245OtherOKRR MEDICARE

National Provider Directory

National Provider Directory

Locations

2905 United Founders Blvd
Specialists Surgery Ctr
Oklahoma City, OK 73112
Phone (405) 842-0848

4317 W Memorial Rd
Oklahoma City, OK 73134
Phone (405) 755-6240

1111 N Lee Ave
Ste 236
Oklahoma City, OK 73103
Phone (405) 272-9641

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871765065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1547",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653021547",
            "telephone_number": "660-826-5960",
            "fax_number": "660-826-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597900",
            "telephone_number": "405-602-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP DOERNER JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DOERNER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-602-8100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100827590C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF2245",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.