Provider Demographics
NPI:1871285734
Name:KIRKPATRICK, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NE 53RD ST APT 3124
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-1887
Mailing Address - Country:US
Mailing Address - Phone:717-953-6667
Mailing Address - Fax:
Practice Address - Street 1:11 PALM AVE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5645
Practice Address - Country:US
Practice Address - Phone:405-354-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist