Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Prairie Gardens Medical LLC

Organization General Practice Physician · NPI 1689280067

Prairie Gardens Medical LLC provides General Practice Physician services in Oklahoma City, Oklahoma. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1213 NW 122nd St Ste 401
Oklahoma City, OK 73114-7000
Phone: (405) 962-9123
Fax: (405) 962-8125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1689280067
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dianne Tupper — Practice Manager · (405) 742-8898
NPI enumeratedSeptember 21, 2020
Last updated in NPPESSeptember 29, 2020
Certification dateSeptember 29, 2020
Mailing address175 Lary Ln, Guthrie, OK 73044-6542

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