Provider Demographics
NPI:1437274446
Name:FRED STRIBLING, M.D., P.C.
Entity Type:Organization
Organization Name:FRED STRIBLING, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:STRIBLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-243-1002
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-0645
Mailing Address - Country:US
Mailing Address - Phone:580-243-1002
Mailing Address - Fax:580-243-1003
Practice Address - Street 1:1710 W 3RD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-5159
Practice Address - Country:US
Practice Address - Phone:580-243-1002
Practice Address - Fax:580-243-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK226782084P0800X
FLME711922084P0800X
PAMD058533L2084P0800X
WAMD000476932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6726Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER