Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25 | OK |
NPI | 1013323815 |
---|---|
Provider Name | Daniel Dorton |
First Address | Lawton, OK 73505-6332 |
Second Address | Lawton, OK 73505-6332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 01/07/2014 |