Doctor Name: | DR. KYLE R JUDKINS |
NPI Number: | 1316271836 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 28018 |
Business Practice Address: | 15951 Little Axe Dr Norman, OK - 730269088 |
Business Phone Number: | 4054470300 |
Business Fax Number: | 4057017914 |
Mailing Address: | 15951 Little Axe Dr, NORMAN |
State: | OK |
Postal Code: | 730269088 |
Phone Number: | 4054470300 |
Fax Number: | 4057017914 |
NPI Enumeration Date: | 09/30/2009 |
NPI Last Update Date: | 06/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 28018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |