Individual
KENNETH D PARROTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 N 6TH ST, OKEENE, OK 73763
(580) 822-4404
(580) 822-4403
Mailing address
124 N 6TH ST, OKEENE, OK 73763
(580) 822-4404
(580) 822-4403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12530
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100122630A
—
OK
01
—
731185962002
BCBS
OK
01
—
P00473633
RAILROAD MEDICARE
—
Enumeration date
06/15/2006
Last updated
01/25/2010
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