Provider Demographics
NPI:1467450692
Name:KREHBIEL, TODD ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ANTHONY
Last Name:KREHBIEL
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 1:14024 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1006
Mailing Address - Country:US
Mailing Address - Phone:405-419-8420
Mailing Address - Fax:405-419-7745
Practice Address - Street 1:2117 N. KELLY AVE.
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-3908
Practice Address - Country:US
Practice Address - Phone:405-726-2701
Practice Address - Fax:405-726-2702
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18489207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00091305OtherRAILROAD MEDICARE
OK100136830DMedicaid
L012101164Medicare PIN
OK100136830DMedicaid