MR. ALTON MATLOCK (NPI# 1013348200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013348200 |
| Entity Type | Individual |
| Full Name | MR. ALTON MATLOCK |
| Practice Address |
2101 Winter Park Drive Apt/suite Sallisaw OK 74955 |
| Mailing Address |
2101 Winterpark Dr Apt/suite Sallisaw OK 74955-7605 |
| Practice Telephone | 4792210724 |
| Mailing Telephone | 4792210724 |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
2101 WINTER PARK DRIVE APT/SUITE |
| City | SALLISAW |
| State | OK |
| Zip Code | 74955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057297 | Audrey A. Martin | Technician | 463508 East 1044 Road, Sallisaw, OK 74955 | 2019-11-12 |
| 1013472356 | Christopher Alan Bush | Registered Nurse | 301 Jt Stites, Sallisaw, OK 74955 | 2019-01-31 |
| 1174098941 | Sequoyah County Drug Company Pllc | Pharmacy | 1632 S Kerr Blvd, Sallisaw, OK 74955 | 2018-10-09 |
| 1720570609 | Stephanie Choate | Registered Nurse | 2703 E Phillips Ave, Sallisaw, OK 74955 | 2018-06-05 |
| 1972964666 | Sallisaw Family Medicine, L.L.C. | Family Medicine | 104 South Oak St, Sallisaw, OK 74955 | 2016-03-09 |
| 1407258544 | Mika Goff | Counselor | 301 So. Jt Stites, Sallisaw, OK 74955 | 2014-09-19 |
| 1881931509 | Wildhorse Family Practice & Urgent Care | Clinic/Center | 1024 W Cherokee, Sallisaw, OK 74955 | 2013-01-15 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| 1194081547 | Peters Agency Hospice and Pallitative Care, LLC | Home Health | 1015 E. Choctaw, Sallisaw, OK 74955 | 2012-04-10 |
| Find all providers in zip 74955 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740656115 | Susan Smith | Counselor | 108089 S 4670 Rd, Sallisaw, OK 74955-8587 | 2015-08-19 |
| 1619383783 | Miriam Wall | Counselor | 205 S J T Stites, Sallisaw, OK 74955-9301 | 2014-07-09 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1497005755 | Johnny Dale Dority I | Counselor | 907 S Walnut St, Sallisaw, OK 74955-6841 | 2012-09-14 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| 1124391859 | Jarrod Neal James | Counselor | 205 South J.t. Stites, Sallisaw, OK 74955 | 2012-02-10 |
| 1407160195 | Sarah Brook Jackson | Counselor | Hc 61 Box 272-4, Sallisaw, OK 74955-9440 | 2010-08-05 |
| 1174842215 | Jessica Randolph | Counselor | 205 S. Jt Stites, Sallisaw, OK 74955-9301 | 2010-05-28 |
| 1164741583 | June Flute | Counselor | 1117 Brown St., Sallisaw, OK 74955 | 2010-05-25 |
| 1659690121 | Melinda Oneal | Counselor | 702 E Mary, Sallisaw, OK 74955 | 2010-05-24 |
| Find all providers in SALLISAW | ||||
Please comment or provide details below to improve the information on MR. ALTON MATLOCK.
| 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.