Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 2007013978 | MO |
Y | 2086S0105X | Surgery of the Hand | 28846 | OK |
N | 2086S0105X | Surgery of the Hand | MD60016648 | WA |
NPI | 1235321472 |
---|---|
Provider Name | David B Mokhtee |
First Address | Tulsa, OK 74146-5822 |
Second Address | Tulsa, OK 74146-5822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2007 |
Last Update Date | 10/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200410860A | (05) | OK |