Provider Demographics
NPI:1679724793
Name:MCCAIN, KENT L (RRT)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:L
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
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Mailing Address - Street 1:6767 S YALE AVE # B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3302
Mailing Address - Country:US
Mailing Address - Phone:918-488-9992
Mailing Address - Fax:918-488-9992
Practice Address - Street 1:3500 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2411
Practice Address - Country:US
Practice Address - Phone:918-331-1904
Practice Address - Fax:918-331-1103
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2498227900000X, 2279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2498OtherOKLAHOMA MEDICAL BOARD