Provider Demographics
NPI:1316464498
Name:CONANT, MICHAEL LINDSEY
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LINDSEY
Last Name:CONANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 36TH AVE NW STE 200
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4113
Mailing Address - Country:US
Mailing Address - Phone:405-990-0816
Mailing Address - Fax:405-735-6116
Practice Address - Street 1:1139 36TH AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4113
Practice Address - Country:US
Practice Address - Phone:405-990-0816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator