Provider Demographics
NPI:1881331700
Name:MOFFETT, NIALL JAMES (MD)
Entity type:Individual
Prefix:MR
First Name:NIALL
Middle Name:JAMES
Last Name:MOFFETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15951 LITTLE AXE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-9088
Mailing Address - Country:US
Mailing Address - Phone:405-447-0300
Mailing Address - Fax:
Practice Address - Street 1:608 NW 9TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1015
Practice Address - Country:US
Practice Address - Phone:405-231-3000
Practice Address - Fax:405-272-7452
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK39639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine