Roundtree, Joe M

Roundtree, Joe M is an individual health care provider with primary practice located at 104 Nw 31St , Lawton OK 73505. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Roundtree, Joe M can be contacted via phone (580) 536-2121.

Contact Information

Primary practice address
104 Nw 31St Lawton OK 73505
Phone: (580) 536-2121
Fax: (580) 536-2150
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 12278 Oklahoma

Profile Details

NPI number 1962596148
LBN Legal business name Roundtree, Joe M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jan 29th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962596148 NPPES
Oklahoma Other 020003594 RAILROAD MEDICARE
Oklahoma Other 37D0686457 RAILROAD MEDICARE
Oklahoma MEDICAID 100123090A RAILROAD MEDICARE

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