Provider Demographics
NPI:1144215971
Name:NIGHTENGALE, MARKHAM L (M D)
Entity type:Individual
Prefix:
First Name:MARKHAM
Middle Name:L
Last Name:NIGHTENGALE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-0305
Mailing Address - Country:US
Mailing Address - Phone:918-481-4706
Mailing Address - Fax:918-481-4765
Practice Address - Street 1:4200 E SKELLY DR STE 700
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3256
Practice Address - Country:US
Practice Address - Phone:918-438-7050
Practice Address - Fax:918-221-0835
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18311207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100131480AMedicaid
OKE19521Medicare UPIN