Provider Demographics
NPI:1700903101
Name:OKLAHOMA FOOT AND ANKLE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:OKLAHOMA FOOT AND ANKLE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:405-794-6691
Mailing Address - Street 1:600 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3617
Mailing Address - Country:US
Mailing Address - Phone:405-340-9251
Mailing Address - Fax:405-340-0686
Practice Address - Street 1:3001 S TELEPHONE RD
Practice Address - Street 2:SUITE B
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5423
Practice Address - Country:US
Practice Address - Phone:405-794-6691
Practice Address - Fax:405-794-9856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK5502790001Medicare NSC
700522161Medicare PIN
OKP00252086Medicare PIN