Provider Demographics
NPI:1194894915
Name:ARCHER, ROBERT L (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:ARCHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4221 S WESTERN AVE STE 2010
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3445
Mailing Address - Country:US
Mailing Address - Phone:405-644-5120
Mailing Address - Fax:405-644-5309
Practice Address - Street 1:4221 S WESTERN AVE STE 2010
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3445
Practice Address - Country:US
Practice Address - Phone:405-644-5120
Practice Address - Fax:405-644-5309
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK1962208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)