PSYDOC LLC (NPI# 1003209057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003209057 |
| Entity Type | Organization |
| Organization Name | PSYDOC LLC |
| Practice Address |
309 N Redbud Ave Broken Arrow OK 74012-2376 |
| Mailing Address |
Po Box 1325 Broken Arrow OK 74013-1325 |
| Practice Telephone | 9188137682 |
| Mailing Telephone | 9188137682 |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |
| Authorized Official Name | STEPHEN PATTON (MD, OWNER) |
| Authorized Official Telephone | 9188137682 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | PSYDOC LLC | 1312 S Beech Ct, Broken Arrow, OK 74012 |
| Street Address |
309 N REDBUD AVE |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-2376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205817210 | Stephen Michael Patton | Psychiatry & Neurology | 309 N Redbud Ave, Broken Arrow, OK 74012-2376 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265514715 | Donna Fenton Gibson | Psychiatry & Neurology | 2501 Cummings Dr, Oklahoma City, OK 73107-2108 | 2006-10-20 |
| 1851611602 | Audra Michelle Yadack | Psychiatry & Neurology | 4601 N Classen Blvd, Oklahoma City, OK 73118-4815 | 2010-06-03 |
| 1255591392 | Gs Medical Consultants Inc | Psychiatry & Neurology | 2805 S Bryant Ave, Suite A, Edmond, OK 73013-6159 | 2008-06-12 |
| 1639343650 | Psychiatric Health Corporation | Psychiatry & Neurology | 10101 S Pennsylvania Ave, Suite A, Oklahoma City, OK 73159-6929 | 2008-04-22 |
| 1730260084 | Charles J Alexis | Psychiatry & Neurology | 921 Ne 13th St, Oklahoma City, OK 73104-5007 | 2006-10-17 |
| 1114011764 | Kirsten Matthews Wilkins | Psychiatry & Neurology | 4502 E 41st St, Dept of Psychiatry, Tulsa, OK 74135-9923 | 2006-10-03 |
| 1124052089 | John C. Andrus | Psychiatry & Neurology | 5100 N Brookline Ave, 950, Oklahoma City, OK 73112-3623 | 2006-07-10 |
| 1518903764 | Ernest George Shadid | Psychiatry & Neurology | 3280 Marshall Ave, Norman, OK 73072-8028 | 2006-06-22 |
| 1134199250 | Jimmie D Mcadams Jr. | Psychiatry & Neurology | 6655 S Yale Ave, Laureate Psychiatric Clinic and Hospital, Tulsa, OK 74136-3326 | 2006-01-23 |
| 1629052808 | Patricia A. Costner | Psychiatry & Neurology | 6655 S Yale Ave, Laureate Psychiatric Clinic and Hospital, Tulsa, OK 74136-3326 | 2005-12-01 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.