# ROBERT MILES CHISHOLM III MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427241728
- **Authorized official:** DR. ROBERT MILES CHISHOLM III MD (PROVIDER)
- **Authorized official phone:** (580) 353-1616

## Contact information

- **Practice address:** 605 W GORE BLVD, SUITE 6, LAWTON, OK 73501-3727
- **Practice address phone:** (580) 353-1616
- **Practice address fax:** (580) 353-0052
- **Mailing address:** 605 WEST GORE BLVD., SUITE 6, LAWTON, OK 73501-3701
- **Mailing address phone:** (580) 353-1616
- **Mailing address fax:** (580) 353-0052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22563 | OK | Yes |

## Other

- **Enumeration date:** 08/21/2007
- **Last updated:** 09/10/2010