Provider Demographics
NPI:1134552417
Name:FLICKINGER, CASEY CALVIN (DC)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:CALVIN
Last Name:FLICKINGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 RIVERSIDE PKWY
Mailing Address - Street 2:106G
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7673
Mailing Address - Country:US
Mailing Address - Phone:405-269-3564
Mailing Address - Fax:
Practice Address - Street 1:7877 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3456
Practice Address - Country:US
Practice Address - Phone:918-492-1813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor