Individual
ROBYN D FREELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
301 N MONTE VISTA ST, ADA, OK 74820-4607
(580) 436-5111
(580) 279-1994
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1174
OK
207R00000X
Internal Medicine Physician
1174
OK
363A00000X
Physician Assistant
Primary
1174
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147240A
—
OK
01
—
1174
OKLAHOMA BOARD OF MEDICAL LICENSURE
OK
Enumeration date
03/07/2006
Last updated
11/19/2021
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