STEVEN RANDOLPH MATLOCK (NPI# 1821101627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821101627 |
| Entity Type | Individual |
| Full Name | STEVEN RANDOLPH MATLOCK |
| Credential | DPH |
| Practice Address |
7128 East Reno Avenue Suite A Midwest City OK 73110 |
| Mailing Address |
12008 Rivendell Drive Oklahoma City OK 73170 |
| Practice Telephone | 4057373464 |
| Practice Fax Number | 4057379554 |
| Mailing Telephone | 4056917270 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 9146 | OK | Pharmacy Service Providers |
| Street Address |
7128 EAST RENO AVENUE SUITE A |
| City | MIDWEST CITY |
| State | OK |
| Zip Code | 73110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939377 | Torry E Elston | Technician/Technologist | 5908 Se 15th St, Midwest City, OK 73110 | 2020-10-12 |
| 1083225783 | Daniel B Nguyen | Pharmacist | 1601 S Air Depot, Midwest City, OK 73110 | 2020-08-14 |
| 1114494903 | Tiandrea Jeanae Neal | Behavioral Analyst | 1212 S. Air Depot, Ste 17, Midwest City, OK 73110 | 2018-10-30 |
| 1467902593 | Brian Christopher Lewis | Case Manager/Care Coordinator | 8616 Cedar Ridge Drive, Midwest City, OK 73110 | 2016-10-13 |
| 1669839312 | National Iom, Pllc | Electrodiagnostic Medicine | 1205 S. Air Depot # 102, Midwest City, OK 73110 | 2016-01-26 |
| 1003292210 | Alexandrea Funston | Speech-Language Pathologist | 224 E Blossom Drive, Midwest City, OK 73110 | 2015-08-11 |
| 1184053399 | Ronya Caraway | Community/Behavioral Health | 7901 Ne 10th, B106, Midwest City, OK 73110 | 2013-11-07 |
| 1245678374 | Layfette Lamar Fletcher | Counselor | 405 Delia Street, Midwest City, OK 73110 | 2013-06-11 |
| 1114364163 | Kathryn Ann Gray | Social Worker | 1391 North Midwest Blvd., Midwest City, OK 73110 | 2013-05-31 |
| 1841542545 | Steven Atkins Akinnfest | Counselor | 417 Reed Place, Midwest City, OK 73110 | 2012-10-05 |
| Find all providers in zip 73110 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083225783 | Daniel B Nguyen | Pharmacist | 1601 S Air Depot, Midwest City, OK 73110 | 2020-08-14 |
| 1326519299 | Kunhoo Park | Pharmacist | 6000 E Reno Ave Apt 1408, Midwest City, OK 73110-2014 | 2018-12-17 |
| 1558646422 | My Thi Dung Nguyen | Pharmacist | 101 North Midwest Blvd., Midwest City, OK 73110 | 2011-10-11 |
| 1609165752 | Brian Lee Wagoner | Pharmacist | 1605 Mark Wood St, Midwest City, OK 73130-8454 | 2011-03-29 |
| 1770795890 | Lou Ann Hughes | Pharmacist | 2311 S Sooner Road, Midwest City, OK 73110-2867 | 2007-05-03 |
| 1396822094 | Mark Allen Strimple | Pharmacist | 7201 E Reno Ave Ste A, Midwest City, OK 73110-4484 | 2006-11-01 |
| 1821101585 | Thomas William Wilson | Pharmacist | 7128 E Reno Ave, Suite A, Midwest City, OK 73110-4478 | 2006-08-16 |
| 1861487340 | Justin Blake Wilson | Pharmacist | 1212a S Douglas Blvd, Midwest City, OK 73130-5213 | 2005-09-12 |
| 1265033369 | Sara Beam | Pharmacist | 6521 Se 29th St, Midwest City, OK 73110-3001 | 2020-11-04 |
| 1245830249 | Seth Mcmakin | Pharmacist | 7520 E Reno Ave, Midwest City, OK 73110-4312 | 2020-10-28 |
| Find all providers in MIDWEST CITY | ||||
| City | MIDWEST CITY |
| Zip Code | 73110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.