Provider Demographics
NPI:1548397532
Name:MICHAEL G. NOLEN M.D. PLLC
Entity Type:Organization
Organization Name:MICHAEL G. NOLEN M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGERY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-237-8900
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-1053
Mailing Address - Country:US
Mailing Address - Phone:580-237-8900
Mailing Address - Fax:580-237-4111
Practice Address - Street 1:915 E OWEN K GARRIOTT RD STE H
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6154
Practice Address - Country:US
Practice Address - Phone:580-237-8900
Practice Address - Fax:580-237-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty