Provider Demographics
NPI:1902150600
Name:AIRINGTON, EDWARD JOSEPH
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOSEPH
Last Name:AIRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 28A
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:OK
Mailing Address - Zip Code:74572-9705
Mailing Address - Country:US
Mailing Address - Phone:580-927-6914
Mailing Address - Fax:
Practice Address - Street 1:705 W 13TH ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-3712
Practice Address - Country:US
Practice Address - Phone:580-889-5555
Practice Address - Fax:580-889-1925
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management