Dr. Brent Wade Davis, D.O.
Family Medicine in Weleetka, OK. Individual provider (NPI-1).
NPI number1619009859
StatusActive
Last updated in NPPESJul 8, 2011
Details
- NPI
- 1619009859
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brent Wade Davis
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2007
- Last updated
- Jul 8, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 1913 | OK | Yes |
Practice location
315 W. 9 StreetWeleetka, OK 74880-0337
Phone 405-786-2248 · Fax 405-786-2006
Mailing address
Po Box 207Henryetta, OK 74437-0207
Phone 405-786-2248 · Fax 405-786-2006
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