Individual provider · NPI-1

Gregory Keyton Blaylock

Family Medicine · Muskogee, OK

NPI number1982274684
StatusActive
Last updated in NPPESJul 21, 2026

Details

NPI
1982274684
Entity type
Individual (NPI-1)
Name
Gregory Keyton Blaylock
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 25, 2021
Certification date
Jul 21, 2026
Last updated
Jul 21, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine8603OKYes

Practice location

350 S 40th St
Muskogee, OK 74401-4915

Phone 918-684-2663 · Fax 918-681-6804

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3333

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