Provider Demographics
NPI:1770824146
Name:ALFORD, MARQUIZ (MED)
Entity Type:Individual
Prefix:MR
First Name:MARQUIZ
Middle Name:
Last Name:ALFORD
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10212 N MILITARY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-4938
Mailing Address - Country:US
Mailing Address - Phone:405-749-4681
Mailing Address - Fax:
Practice Address - Street 1:8901 S SANTA FE AVE
Practice Address - Street 2:STE. E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8413
Practice Address - Country:US
Practice Address - Phone:405-605-5757
Practice Address - Fax:405-605-5775
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor