DR. ROBERT MILES CHISHOLM III (NPI# 1205941762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205941762 |
| Entity Type | Individual |
| Full Name | DR. ROBERT MILES CHISHOLM III |
| Credential | M.D. |
| Practice Address |
605 W Gore Blvd Suite 6 Lawton OK 73501-3727 |
| Practice Telephone | 5803531616 |
| Practice Fax Number | 5803530052 |
| Mailing Telephone | 5803531616 |
| Mailing Fax Number | 5803530052 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | 22563 | OK | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 080185221 | 01 | |
| OK | 100108500B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861587792 | Robert C Chisholm | Dentist | 36640 Fremont Blvd, Suite A, Fremont, CA 94536-3630 | 2006-10-04 |
| 1245465574 | Robert A Chisholm | Dentist | 10497 Town and Country Way, #914, Houston, TX 77024-1117 | 2009-05-15 |
| 1760445415 | Robert William Chisholm | Emergency Medicine | 342 Fairview St, Silverton, OR 97381-1917 | 2006-04-11 |
| Street Address |
605 W GORE BLVD SUITE 6 |
| City | LAWTON |
| State | OK |
| Zip Code | 73501-3727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184082976 | Ithrive Counseling Services, LLC | Counselor | 605 W Gore Blvd, Suite 3, Lawton, OK 73501-3727 | 2016-02-08 |
| 1962756759 | Porscha Millender | Counselor | 605 W Gore Blvd, Suite 5a, Lawton, OK 73501-3727 | 2012-11-01 |
| 1013265727 | Cynthia Marie Osuna | Counselor | 605 W Gore Blvd, Suite 3, Lawton, OK 73501-3727 | 2012-08-28 |
| 1427318203 | Deanice Shegog | Counselor | 605 W Gore Blvd, Suite 5a, Lawton, OK 73501-3727 | 2012-05-25 |
| 1427241728 | Robert Miles Chisholm IIi Md Pllc | Family Medicine | 605 W Gore Blvd, Suite 6, Lawton, OK 73501-3727 | 2007-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 170100000X |
| Grouping | Other Service Providers |
| Classification | Medical Genetics, Ph.D. Medical Genetics |
| A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
| Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194044313 | Wallace B Mcleod IIi, Inc | Medical Genetics, Ph.D. Medical Genetics | 2216 N Martin Luther King Ave, Oklahoma City, OK 73111-2445 | 2010-05-27 |
| 1861711731 | Wallace B. Mcleod IIi, Inc | Medical Genetics, Ph.D. Medical Genetics | 2216 N Martin Luther King Ave, Oklahoma City, OK 73111-2445 | 2010-05-18 |
| 1639388804 | Nancy Satzler Md PC | Medical Genetics, Ph.D. Medical Genetics | 3366 Nw Expressway St, Suite 280, Oklahoma City, OK 73112-4462 | 2007-05-22 |
| 1306952148 | Nancy Jane Hammond | Medical Genetics, Ph.D. Medical Genetics | 6465 S Yale Ave, Suite 1010, Tulsa, OK 74136-7823 | 2006-08-22 |
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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.