Provider Demographics
NPI:1336222504
Name:MORTON, ROBERT OLIVER (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:OLIVER
Last Name:MORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ROLLING HILLS LN
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-9415
Mailing Address - Country:US
Mailing Address - Phone:580-759-0022
Mailing Address - Fax:580-755-2177
Practice Address - Street 1:1000 ROLLING HILLS LN
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-9415
Practice Address - Country:US
Practice Address - Phone:580-759-0022
Practice Address - Fax:580-759-2177
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK105002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK29454OtherOBNDO
OK100087580AMedicaid
OKBM7560887OtherDEA
D42684Medicare UPIN
OK29454OtherOBNDO