Provider Demographics
NPI:1942280987
Name:FEY, VICTOR L (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:L
Last Name:FEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:90 N 30TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3100
Mailing Address - Country:US
Mailing Address - Phone:580-323-5433
Mailing Address - Fax:580-323-3833
Practice Address - Street 1:90 N 30TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3100
Practice Address - Country:US
Practice Address - Phone:580-323-5433
Practice Address - Fax:580-323-3833
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2014-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK15283207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100107020BMedicaid
OK100107020CMedicaid
OK246718701Medicare PIN
OK100107020BMedicaid