1710270566 NPI number — MR. KEITH LAFAYETTE MCCANN II M.A.

Table of content: MR. KEITH LAFAYETTE MCCANN II M.A. (NPI 1710270566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710270566 NPI number — MR. KEITH LAFAYETTE MCCANN II M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCANN
Provider First Name:
KEITH
Provider Middle Name:
LAFAYETTE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
II
Provider Credential Text:
M.A.
Provider Gender Code:
M

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:
1710270566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2325 S HARVARD AVE STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74114-3304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-712-4301
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8100 E 22ND ST N BLDG 800
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67226-2350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-201-6047
Provider Business Practice Location Address Fax Number:
316-330-3980
Provider Enumeration Date:
05/25/2011

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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