Provider Demographics
NPI:1508827601
Name:MCCOWN, PHILLIP LEE (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:LEE
Last Name:MCCOWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 W ELK AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1642
Mailing Address - Country:US
Mailing Address - Phone:580-251-8881
Mailing Address - Fax:580-251-8883
Practice Address - Street 1:2000 W ELK AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1642
Practice Address - Country:US
Practice Address - Phone:580-251-8881
Practice Address - Fax:580-251-8883
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK9742207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4475107002OtherCIGNA
OK730996732004OtherBLUE CROSS BLUE SHIELD
OKP00220005OtherRAILROAD MEDICARE
OKP00220005OtherRAILROAD MEDICARE