Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 19880 | OK |
NPI | 1356436000 |
---|---|
Provider Name | David Jonathan Siegler |
First Address | Tulsa, OK 74136 |
Second Address | Tulsa, OK 74136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BS3483726 | DEA (01) | OK |
F48856 | (02) |