WILDSTATE LAWTON LLC NPI 1467327759

NPI Information

  • NPI: 1467327759
  • Provider Name: WILDSTATE LAWTON LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 2506 SW LEE BLVD
    LAWTON, OK
    ZIP 73505
  • Phone: (580) 280-2558

Map and Directions

Get Directions

NPI Details

WILDSTATE LAWTON LLC is a clinic center in Lawton, OK. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). WILDSTATE LAWTON LLC NPI is 1467327759. The provider is registered as an organization entity type.

The provider's business location address is:

2506 SW LEE BLVD
LAWTON, OK
ZIP 73505-311
Phone: (580) 280-2558

The provider's authorized official is Crystal Michelle Johnson .
The authorized official title is Owner and has the following contact phone number (580) 280-2558.

The enumeration date for this NPI number is 10/7/2025 and was last updated on 10/20/2025.

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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2261Q00000XClinic/CenterYes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI