Individual
DR. EDGAR ALLEN FIKE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 S 5TH ST STE 301, ENID, OK 73701-5862
(580) 249-3468
(580) 234-5028
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 249-3468
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2010-01833
NC
207X00000X
Orthopaedic Surgery Physician
Primary
20712
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188770A
—
OK
01
—
2077062
MEDICARE ID-TYPE UNSPECIFIED
NC
01
—
2077062A
MEDICARE ID-TYPE UNSPECIFIED
NC
05
—
5916465
—
NC
Enumeration date
10/17/2006
Last updated
02/16/2018
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