Provider Demographics
NPI:1316279219
Name:IRBY, MICHAEL W (AUD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:IRBY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:432 S MUSTANG RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7312
Mailing Address - Country:US
Mailing Address - Phone:405-265-1133
Mailing Address - Fax:405-265-1144
Practice Address - Street 1:432 S MUSTANG RD
Practice Address - Street 2:SUITE B
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7312
Practice Address - Country:US
Practice Address - Phone:405-265-1133
Practice Address - Fax:405-265-1144
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK272237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter