Provider Demographics
NPI:1497398671
Name:DOCOK1
Entity Type:Organization
Organization Name:DOCOK1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PRACTICE DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMOINE MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-983-0303
Mailing Address - Street 1:5040 ADDISON CIR STE 400
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6049
Mailing Address - Country:US
Mailing Address - Phone:214-983-0303
Mailing Address - Fax:
Practice Address - Street 1:3130 SW 89TH ST STE 200E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7908
Practice Address - Country:US
Practice Address - Phone:405-673-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty