# KEVIN M. RICCITELLI, D.O. LLC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1881747806
- **Authorized official:** DR. KEVIN MARK RICCITELLI D.O. (PHYSICIAN OWNER)
- **Authorized official phone:** (580) 248-1199

## Contact information

- **Practice address:** 916 SW 38TH ST, SUITE D., LAWTON, OK 73505-7005
- **Practice address phone:** (580) 248-1199
- **Practice address fax:** (580) 248-3679
- **Mailing address:** 916 SW 38TH ST, SUITE D., LAWTON, OK 73505-7005
- **Mailing address phone:** (580) 248-1199
- **Mailing address fax:** (580) 248-3679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2220 | OK | Yes |

## Other

- **Enumeration date:** 01/21/2007
- **Last updated:** 10/24/2007