EVERSIDE HEALTH CENTER-MICHELIN ARDMORE NPI 1669149324

NPI Information

  • NPI: 1669149324
  • Provider Name: EVERSIDE HEALTH CENTER-MICHELIN ARDMORE
  • Classification: Preventive Medicine - 2083P0500X
  • Specialization: Preventive Medicine/Occupational Environmental Medicine
  • Entity Type: Organization
  • CLIA Number: 37D2240291
  • Address: 1105 MICHELIN RD
    ARDMORE, OK
    ZIP 73401
  • Phone: (580) 224-8750

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NPI Details

EVERSIDE HEALTH CENTER-MICHELIN ARDMORE is a preventive medicine/occupational environmental medicine preventive medicine in Ardmore, OK. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. EVERSIDE HEALTH CENTER-MICHELIN ARDMORE NPI is 1669149324. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1105 MICHELIN RD
ARDMORE, OK
ZIP 73401-085
Phone: (580) 224-8750

The provider's authorized official is Jill Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 37D2240291 - other - chronic disease mgt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2021 and was last updated on 12/1/2021.

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
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineYes

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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