IndividualActive
Larry Elliott
NPI 1770933277 · Family Medicine Physician · Fairview, OK
Provider details
- NPI number
- 1770933277
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 6155 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
523 E State Rd
Fairview, OK 73737-1453
Phone: (580) 227-3721
Fax: (580) 227-2882
Approximate (ZIP-level) locationGet directions
Mailing address
523 E State Rd
Fairview, OK 73737-1453
Registry dates
- Enumerated
- 2016-06-15
- Last updated
- 2022-03-23
- Certified
- 2022-03-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.