Provider Demographics
NPI:1881672707
Name:COMPTON SHOE INC
Entity Type:Organization
Organization Name:COMPTON SHOE INC
Other - Org Name:COMPTON ORTHOPEDIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARLON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPED MED BS
Authorized Official - Phone:405-946-3668
Mailing Address - Street 1:3703 NW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2553
Mailing Address - Country:US
Mailing Address - Phone:405-946-3668
Mailing Address - Fax:405-946-1650
Practice Address - Street 1:3703 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2553
Practice Address - Country:US
Practice Address - Phone:405-946-3668
Practice Address - Fax:405-946-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100806500AMedicaid