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

Wildstate Lawton LLC

Organization Clinic/Center · NPI 1467327759

Wildstate Lawton LLC is a Clinic/Center in Lawton, Oklahoma. Works from 2 locations. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
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

2506 SW Lee Blvd
Lawton, OK 73505-8311
Phone: (580) 280-2558
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2504 Sw Lee Blvd, Lawton, OK 73505-8311 — (580) 250-1999

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1467327759
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Crystal Johnson — Owner · (580) 280-2558
NPI enumeratedOctober 7, 2025
Last updated in NPPESOctober 20, 2025
Certification dateOctober 20, 2025
Mailing address2506 Sw Lee Blvd, Lawton, OK 73505-8311

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