NPI 1194068049
Kevin Edmondson
Practice location
- Address
- 1350 S Muldrow St, Tishomingo, OK 73460-3278
- Phone
- (580) 579-9939
Registered specialties
Case Manager/Care Coordinator
Primary
Registry record
- NPI
- 1194068049
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 28 Mar 2013
- Record last updated
- 28 Mar 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.