Provider Demographics
NPI:1144414608
Name:CURTIS SCHENK MD
Entity Type:Organization
Organization Name:CURTIS SCHENK MD
Other - Org Name:WATONGA FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SCHENK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-623-4954
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:WATONGA
Mailing Address - State:OK
Mailing Address - Zip Code:73772-3636
Mailing Address - Country:US
Mailing Address - Phone:580-623-4954
Mailing Address - Fax:580-623-4980
Practice Address - Street 1:407 N CLARENCE NASH
Practice Address - Street 2:
Practice Address - City:WATONGA
Practice Address - State:OK
Practice Address - Zip Code:73772-3636
Practice Address - Country:US
Practice Address - Phone:580-623-4954
Practice Address - Fax:580-623-4954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CURTIS SCHENK MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-28
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100124040AMedicaid
OK100732480DMedicaid
OK100732480CMedicaid
OK100732480DMedicaid
373854Medicare Oscar/Certification