Provider Demographics
NPI:1992137152
Name:FMO PLLC
Entity type:Organization
Organization Name:FMO PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIPOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-848-7246
Mailing Address - Street 1:6500 N MERIDIAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1403
Mailing Address - Country:US
Mailing Address - Phone:405-848-7246
Mailing Address - Fax:405-842-8290
Practice Address - Street 1:6500 N MERIDIAN AVE STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1403
Practice Address - Country:US
Practice Address - Phone:405-848-7246
Practice Address - Fax:405-842-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty