Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 0016442 | TX |
Y | 1223G0001X | General Practice | 3597 | OK |
Y | 213EG0000X | General Practice | 3597 | OK |
NPI | 1194766188 |
---|---|
Provider Name | Dr. John R. Mcdavid |
First Address | Warr Acres, OK 73122-2005 |
Second Address | Warr Acres, OK 73122-2005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 12/01/2012 |