Provider Demographics
NPI:1134453202
Name:GARLAND PORTERFIELD, MD INC.
Entity type:Organization
Organization Name:GARLAND PORTERFIELD, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:N
Authorized Official - Last Name:PORTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-848-9700
Mailing Address - Street 1:3727 N.W. 63RD. ST.
Mailing Address - Street 2:#200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116
Mailing Address - Country:US
Mailing Address - Phone:405-848-9700
Mailing Address - Fax:405-848-7297
Practice Address - Street 1:3727 N.W. 63RD. ST.
Practice Address - Street 2:#200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-848-9700
Practice Address - Fax:405-848-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10681208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty