Provider Demographics
NPI:1205879772
Name:PARKHURST, JOSEPH D (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:PARKHURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 N THOMPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5307
Mailing Address - Country:US
Mailing Address - Phone:405-495-6134
Mailing Address - Fax:405-787-8466
Practice Address - Street 1:2349 N THOMPKINS AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5307
Practice Address - Country:US
Practice Address - Phone:405-495-6134
Practice Address - Fax:405-787-8466
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11526208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100105760AMedicaid
OKBC/BSOther202130641014
OKBC/BSOther202130641014
OKC95333Medicare UPIN
OKP00382434Medicare PIN
OK24C707307Medicare PIN