Provider Demographics
NPI:1669652145
Name:PHILIP A. FLOYD, M.D.,P.C.
Entity Type:Organization
Organization Name:PHILIP A. FLOYD, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-286-5557
Mailing Address - Street 1:PO BOX 25016
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73125-0016
Mailing Address - Country:US
Mailing Address - Phone:405-286-5557
Mailing Address - Fax:405-286-5680
Practice Address - Street 1:2800 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-4839
Practice Address - Country:US
Practice Address - Phone:405-286-5557
Practice Address - Fax:405-286-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21042261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK568029491 003OtherBC/BS
OKG92055OtherUPIN