Provider Demographics
NPI:1255322111
Name:LOVE, ROBERT MILTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MILTON
Last Name:LOVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 SW LEE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9678
Mailing Address - Country:US
Mailing Address - Phone:580-536-4585
Mailing Address - Fax:580-536-2423
Practice Address - Street 1:6401 SW LEE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9678
Practice Address - Country:US
Practice Address - Phone:580-536-4585
Practice Address - Fax:580-536-2423
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100733800AMedicaid
OK100733800AMedicaid