Provider Demographics
NPI:1255784393
Name:KMZ MEDICAL SOLUTIONS, PLLC
Entity type:Organization
Organization Name:KMZ MEDICAL SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ZANN
Authorized Official - Last Name:MCMAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-726-2727
Mailing Address - Street 1:800 W 18TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3758
Mailing Address - Country:US
Mailing Address - Phone:405-726-2727
Mailing Address - Fax:405-216-5724
Practice Address - Street 1:800 W. ST.
Practice Address - Street 2:STE 102-C
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-7920
Practice Address - Country:US
Practice Address - Phone:405-210-2202
Practice Address - Fax:405-216-5724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-13
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK24591261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty