Provider Demographics
NPI:1023336542
Name:HOUSMAN, ABBY MARIE (DO)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:MARIE
Last Name:HOUSMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:ABBY
Other - Middle Name:MARIE
Other - Last Name:SCHOELEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 W IOWA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-2736
Mailing Address - Country:US
Mailing Address - Phone:405-224-2100
Mailing Address - Fax:405-779-2855
Practice Address - Street 1:2100 W IOWA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2736
Practice Address - Country:US
Practice Address - Phone:405-224-2100
Practice Address - Fax:405-779-2855
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200349940AMedicaid
296245YML1Medicare PIN
P01323912Medicare PIN
OK200349940AMedicaid