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

Ketamine Ok LLC

Organization Psychiatry Physician · NPI 1649738865

Ketamine Ok LLC is a Psychiatry Physician in Moore, Oklahoma. Registered with an NPI since 2019.

In the registry since
2019
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

1105 SW 30th Ct
Moore, OK 73160-2887
Phone: (405) 703-0937
Fax: (405) 378-2776
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1649738865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Julie Dudley — Practice Manager · (405) 703-0937
Other names Ketamine Ok Llc
NPI enumeratedMarch 6, 2019
Last updated in NPPESMarch 6, 2019
Mailing address1105 Sw 30th Ct, Moore, OK 73160-2887

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