Provider Demographics
NPI:1902681869
Name:FINNELL, ROBERT L
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:FINNELL
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 1:20296 MILFAY RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:OK
Mailing Address - Zip Code:74028-3606
Mailing Address - Country:US
Mailing Address - Phone:918-346-5716
Mailing Address - Fax:
Practice Address - Street 1:20296 MILFAY RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:OK
Practice Address - Zip Code:74028-3606
Practice Address - Country:US
Practice Address - Phone:918-346-5716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty