Provider Demographics
NPI:1053348615
Name:SIPES, BILLY H (MD)
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:H
Last Name:SIPES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:520 S MUSTANG RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6737
Practice Address - Country:US
Practice Address - Phone:405-936-5910
Practice Address - Fax:405-577-2605
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK10535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100094100AMedicaid
OK10535OtherLICENSE
OK080000061OtherRAILROAD
OK20138OtherOBNDD
OK20138OtherOBNDD
OK244431010Medicare PIN