Provider Demographics
NPI:1154606812
Name:TALKINGTON, DEREK M (MA)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:M
Last Name:TALKINGTON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NE 53RD ST APT 3106
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-1886
Mailing Address - Country:US
Mailing Address - Phone:405-535-7795
Mailing Address - Fax:
Practice Address - Street 1:5208 CLASSEN CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4429
Practice Address - Country:US
Practice Address - Phone:405-810-1766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)