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Contact Information

SOUTHERN OKLAHOMA KIDNEY CENTER INC
2611 CROSSROADS DRIVE
ARDMORE, OK73401
 Phone: 580-223-8614
 Fax: 580-223-2561
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nephrology

207RN0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SOUTHERN OKLAHOMA KIDNEY CENTER INC

NPI Number 1538273958
LBN Legal business name SOUTHERN OKLAHOMA KIDNEY CENTER INC
Authorized official ABDUL KHAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/19/2006
Last updated 09/02/2025 - About 9 months ago
Identifiers
OK Medicaid 200124150A
TX Medicaid 194130401
OK Other DN6026 MEDICARE RAILROAD
TX Other DN6026 MEDICARE RAILROAD
TX Other DP2512 RAILROAD MEDICARE TX
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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