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

Canyon Park Medical Group, PLLC

Organization Primary Care Clinic/Center · NPI 1063525954

Canyon Park Medical Group, PLLC is a Primary Care Clinic/Center in Edmond, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2006.

Licensed in
OK
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1501 E 19th St
Edmond, OK 73013-6618
Phone: (405) 348-6611
Fax: (405) 348-9280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 8699 (OK)

Record details

NPI number1063525954
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tonya Keith — Clinic Manager · (405) 348-6611
NPI enumeratedAugust 16, 2006
Last updated in NPPESMay 2, 2011
Mailing address1501 E 19th St, Edmond, OK 73013-6618

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