Provider Demographics
NPI:1740481977
Name:MIKEL, ROBIN MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MICHELLE
Last Name:MIKEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-713-4400
Mailing Address - Fax:405-713-4473
Practice Address - Street 1:3435 NW 56TH ST STE 600
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4442
Practice Address - Country:US
Practice Address - Phone:405-713-4400
Practice Address - Fax:405-713-4473
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4450207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200182000AMedicaid
OKOK401559Medicare PIN