GLENN LYTLE (NPI# 1194702167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194702167 |
| Entity Type | Individual |
| Full Name | GLENN LYTLE |
| Credential | MD |
| Practice Address |
3801 W Utica St Broken Arrow OK 74011-1365 |
| Practice Telephone | 9182861920 |
| Practice Fax Number | 9182861920 |
| Mailing Telephone | 9182861920 |
| Mailing Fax Number | 9182861920 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2014-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 16019 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
3801 W UTICA ST |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74011-1365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336663699 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Ste 101, Broken Arrow, OK 74011 | 2017-07-28 |
| 1053833608 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Suite 101, Broken Arrow, OK 74011 | 2017-07-14 |
| 1184079709 | Melissa David | Lactation Consultant, Non-RN | 417 West San Diego St., Broken Arrow, OK 74011 | 2016-05-02 |
| 1154789576 | Rebecca Young | Registered Nurse | 7801 S Oak Pl, Broken Arrow, OK 74011 | 2016-01-29 |
| 1942524061 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 751 W Tuscan St, 121st, Broken Arrow, OK 74011 | 2010-03-18 |
| 1174764336 | Linda J. Russell | Counselor | 2446 W New Orleans St, Broken Arrow, OK 74011 | 2009-03-18 |
| 1851409080 | Kim Lee Mcneal | Dentist | 3764 South Elm Place, Broken Arrow, OK 74011 | 2006-08-28 |
| 1669433249 | Matthew E Ozment | Optometrist | 2500 West New Orleans, Broken Arrow, OK 74011 | 2006-03-31 |
| 1912275140 | Courtney Brooke Willcoxon | Pharmacist | 4704 S Elm Pl, Broken Arrow, OK 74011 | 2011-12-02 |
| 1558322883 | Gerald Seefeldt | Family Medicine | 66 Cedar Ridge Rd, Broken Arrow, OK 74011-1101 | 2006-03-28 |
| Find all providers in zip 74011 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139554 | Crestcare Family Medicine,pllc | Family Medicine | 817 S Elm Pl Ste 104, Broken Arrow, OK 74012-5369 | 2020-09-21 |
| 1346855640 | Charger Health Group Pllc | Family Medicine | 511 N Aspen Ave, Broken Arrow, OK 74012-2220 | 2020-09-14 |
| 1730606294 | Tulsa Pain Care Group LLC | Family Medicine | 817 S Elm Pl Ste 106, Broken Arrow, OK 74012-5369 | 2017-08-25 |
| 1760912075 | Total Care Physicians Group | Family Medicine | 2601 N Aspen Ave Ste 1011, Broken Arrow, OK 74012-1127 | 2017-06-19 |
| 1922441591 | Medstaff PC | Family Medicine | 1749 N Aspen Ave, Suite 1757, Broken Arrow, OK 74012 | 2013-04-12 |
| 1528388717 | Robert L Valentine | Family Medicine | 1801 E Kenosha St, Broken Arrow, OK 74012-2098 | 2010-06-10 |
| 1235468745 | King's Court Family Medicine | Family Medicine | 1615 S Eucalyptus Ave Ste 211, Broken Arrow, OK 74012-5993 | 2009-12-11 |
| 1306967088 | Cathleen E Vandergriff | Family Medicine | 2643 E Albany St Apt C, Broken Arrow, OK 74014-4634 | 2007-04-02 |
| 1053431452 | Family Care of Broken Arrow, Inc. | Family Medicine | 3100 S. Elm Pl., Suite A, Broken Arrow, OK 74012-7910 | 2007-03-30 |
| 1659405488 | Broken Arrow Family Practice Center | Family Medicine | 817 S Elm Pl Ste A, Broken Arrow, OK 74012-5369 | 2007-03-15 |
| Find all providers in BROKEN ARROW | ||||
| City | BROKEN ARROW |
| Zip Code | 74011 |
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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.