Individual
ROBERT C BALOGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 W GORE, LAWTON, OK 73505
(580) 510-7037
(580) 510-7038
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
102704
MN
207R00000X
Internal Medicine Physician
Primary
25362
OK
207R00000X
Internal Medicine Physician
45039
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200103050A
—
OK
01
—
247707803
MEDICARE ID
OK
Enumeration date
06/28/2006
Last updated
08/04/2008
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