Provider Demographics
NPI:1649682519
Name:PATRIOT PROSTHETICS AND ORTHOTICS, INC.
Entity type:Organization
Organization Name:PATRIOT PROSTHETICS AND ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, CEO, PRESIDENT, TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:CP, LPO
Authorized Official - Phone:405-557-6778
Mailing Address - Street 1:1804 COMMONS CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9524
Mailing Address - Country:US
Mailing Address - Phone:405-577-6778
Mailing Address - Fax:
Practice Address - Street 1:1804 COMMONS CIR
Practice Address - Street 2:SUITE A
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-9524
Practice Address - Country:US
Practice Address - Phone:405-577-6778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier