Provider Demographics
NPI:1225519531
Name:METIZ, ANTHONY
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:METIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MILBURN
Mailing Address - State:OK
Mailing Address - Zip Code:73450-9610
Mailing Address - Country:US
Mailing Address - Phone:580-795-6377
Mailing Address - Fax:
Practice Address - Street 1:5912 U.S. HWY 70 EAST
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:OK
Practice Address - Zip Code:73449
Practice Address - Country:US
Practice Address - Phone:580-745-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator