Individual
DR. MICHAEL J IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1001 E JACKSON ST, HUGO, OK 74743-4225
(580) 317-9000
(580) 317-9024
Mailing address
1001 E JACKSON ST, HUGO, OK 74743-4225
(580) 317-9000
(580) 317-9024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3636
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254440B
—
OK
05
—
100254440D
—
OK
Enumeration date
06/26/2006
Last updated
12/24/2009
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