Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 2685 | OK |
NPI | 1164447694 |
---|---|
Provider Name | David W. Behm |
First Address | Oklahoma City, OK 73134-1785 |
Second Address | Lawton, OK 73505-9635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A65373 | (02) | OK |
P00013682 | RR MEDICARE (01) | OK |