Provider Demographics
NPI:1518303536
Name:NEWKIRK, FRANKLIN DELANO ROOSEVELT JR
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:DELANO ROOSEVELT
Last Name:NEWKIRK
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 NW 74TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-4234
Mailing Address - Country:US
Mailing Address - Phone:580-536-6049
Mailing Address - Fax:
Practice Address - Street 1:1111 NW 74TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-4234
Practice Address - Country:US
Practice Address - Phone:580-536-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor