1215948534 NPI number — MS. VERNA KAY FOUST L.P.C., L.B.P.

Table of content: MS. VERNA KAY FOUST L.P.C., L.B.P. (NPI 1215948534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215948534 NPI number — MS. VERNA KAY FOUST L.P.C., L.B.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOUST
Provider First Name:
VERNA
Provider Middle Name:
KAY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.P.C., L.B.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215948534
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 SYCAMORE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEATHERFORD
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73096-2751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-772-0286
Provider Business Mailing Address Fax Number:
580-323-6270

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
94 N 31ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73601-9116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-323-6021
Provider Business Practice Location Address Fax Number:
580-323-6270
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1354 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 0250 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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