Fanning, Kyle
Fanning, Kyle is an individual health care provider with primary practice located at 1401 Sw 34Th St Ste 200 , Moore OK 73160-3059. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fanning, Kyle can be contacted via phone (405) 793-1188.Contact Information
Primary practice address
1401 Sw 34Th St Ste 200
Moore OK 73160-3059
Phone: (405) 793-1188
Fax: (405) 793-0492
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 17631 | Oklahoma |
Profile Details
| NPI number | 1184668998 |
|---|---|
| LBN Legal business name | Fanning, Kyle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Mar 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184668998 | NPPES |
| Oklahoma | MEDICAID | 100197770B | |
| Oklahoma | MEDICAID | 100197770C |
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