Provider Demographics
NPI:1780663070
Name:PRICE, LANDON D (MD)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:D
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4606 E 67TH ST
Mailing Address - Street 2:STE 400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-4943
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:918-488-6010
Practice Address - Street 1:2950 S ELM PL
Practice Address - Street 2:STE 160
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7877
Practice Address - Country:US
Practice Address - Phone:918-449-3750
Practice Address - Fax:918-449-3755
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OK13433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD35153Medicare UPIN