SURGERY CENTER OF LAWTON PROFESSIONAL LLC NPI 1164478764

NPI Information

  • NPI: 1164478764
  • Provider Name: SURGERY CENTER OF LAWTON PROFESSIONAL LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 3617 W GORE BLVD
    SUITE D
    LAWTON, OK
    ZIP 73505
  • Phone: (580) 351-0500

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NPI Details

SURGERY CENTER OF LAWTON PROFESSIONAL LLC is an ambulatory surgical clinic center in Lawton, OK. SURGERY CENTER OF LAWTON PROFESSIONAL LLC NPI is 1164478764. The provider is registered as an organization entity type.

The provider's business location address is:

3617 W GORE BLVD
SUITE D
LAWTON, OK
ZIP 73505-373
Phone: (580) 351-0500
Fax: (580) 351-0500

The provider's authorized official is Rita Williams .
The authorized official title is Administrator and has the following contact phone number (580) 351-0500.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Incision of eardrum with placement of eardrum tube under general anesthesia (HCPCS:69436)
  • Aspiration and/or injection of fluid from medium joint (HCPCS:20605)
  • Correction of toe joint deformity (HCPCS:28285)
  • Reshaping of nasal cartilage (HCPCS:30520)

The enumeration date for this NPI number is 5/25/2006 and was last updated on 3/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical0030OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100522011MEDICARE ID-TYPE UNSPECIFIEDOKLAHOMA
2100745750 AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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