Provider Demographics
NPI:1659328318
Name:MODERNDAY HOUSECALL
Entity Type:Organization
Organization Name:MODERNDAY HOUSECALL
Other - Org Name:MDONCALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-535-0982
Mailing Address - Street 1:2205 WOODFORD WAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6445
Mailing Address - Country:US
Mailing Address - Phone:405-535-0982
Mailing Address - Fax:405-285-0497
Practice Address - Street 1:2205 WOODFORD WAY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6445
Practice Address - Country:US
Practice Address - Phone:405-535-0982
Practice Address - Fax:405-285-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22402207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty