Provider Demographics
NPI:1730184326
Name:NAVARRO, JOHN MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MATTHEW
Last Name:NAVARRO
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 1:1044 SW 44TH ST
Mailing Address - Street 2:STE 600
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3611
Mailing Address - Country:US
Mailing Address - Phone:405-631-4263
Mailing Address - Fax:405-631-4820
Practice Address - Street 1:1044 SW 44TH ST
Practice Address - Street 2:STE 600
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3611
Practice Address - Country:US
Practice Address - Phone:405-631-4263
Practice Address - Fax:405-631-4820
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23253207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG59205Medicare UPIN