Provider Demographics
NPI:1942680087
Name:KIRKPATRICK, BLAIR AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:AUSTIN
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1200 CHILDRENS AVE
Mailing Address - Street 2:OUCP 14000 A2
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4637
Mailing Address - Country:US
Mailing Address - Phone:405-271-4417
Mailing Address - Fax:
Practice Address - Street 1:1515 N PORTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6654
Practice Address - Country:US
Practice Address - Phone:405-366-8619
Practice Address - Fax:405-366-1839
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK31641207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program