Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | L-7005592 | TX |
NPI | 1467700096 |
---|---|
Provider Name | Dr. William Robert Doenges |
First Address | Tulsa, OK 74145 |
Second Address | Tulsa, OK 74145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2012 |
Last Update Date | 29/08/2012 |