Basic Information
| Provider Information | |||||||||
| NPI: | 1720087869 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OATHOUT | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 960219 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731960001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5805481367 | ||||||||
| FaxNumber: | 5805481537 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 S MADISON ST | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | ENID | ||||||||
| State: | OK | ||||||||
| PostalCode: | 737017270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802336350 | ||||||||
| FaxNumber: | 5802336106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2005 | ||||||||
| LastUpdateDate: | 09/27/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 13020 | OK | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.