Provider Demographics
NPI:1669501151
Name:INGLESE, ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:INGLESE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20173
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73156-0173
Mailing Address - Country:US
Mailing Address - Phone:239-896-0974
Mailing Address - Fax:
Practice Address - Street 1:820 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6898
Practice Address - Country:US
Practice Address - Phone:405-943-0303
Practice Address - Fax:405-272-0515
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9141111N00000X
OK4410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9771Medicare ID - Type UnspecifiedGROUP #
FLU94568Medicare UPIN
FLU7346ZMedicare ID - Type UnspecifiedINDIVIDUAL #