OrganizationActive
Miraworx of Okc 1 LLC
NPI 1053641803 · Addiction Medicine (Family Medicine) Physician · Oklahoma City, OK
Provider details
- NPI number
- 1053641803
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Carolyn Davies, Consultant(918) 286-7347
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10400 Vineyard Blvd Apt a
Oklahoma City, OK 73120-3830
Phone: (405) 230-1102
Approximate (ZIP-level) locationGet directions
Mailing address
10400 Vineyard Blvd Apt a
Oklahoma City, OK 73120-3830
Registry dates
- Enumerated
- 2009-12-29
- Last updated
- 2009-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.