Basic Information
Provider Information
NPI: 1184227332
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APLIN
FirstName: ZACHREY
MiddleName: DOUGLAS
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15951 LITTLE AXE DR
Address2:  
City: NORMAN
State: OK
PostalCode: 730269088
CountryCode: US
TelephoneNumber: 4054470300
FaxNumber: 4057017631
Practice Location
Address1: 940 STANTON L YOUNG BLVD STE 357
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731045020
CountryCode: US
TelephoneNumber: 5805646302
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/19/2020
LastUpdateDate: 03/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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