Provider Demographics
NPI:1053351379
Name:VILLINES, FLOYD SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:SCOTT
Last Name:VILLINES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 S PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-6102
Mailing Address - Country:US
Mailing Address - Phone:469-450-6280
Mailing Address - Fax:
Practice Address - Street 1:637 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OK
Practice Address - Zip Code:73077-6635
Practice Address - Country:US
Practice Address - Phone:405-987-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6497111N00000X
OK4305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605062Medicaid
TX001783201Medicaid
TX8M5360OtherBC/BS
TX001783201Medicaid
TX605062Medicare PIN