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 is a General Practice Physician 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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