Basic Information
| Provider Information | |||||||||
| NPI: | 1811194749 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABERNETHY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 W MEMORIAL RD | ||||||||
| Address2: | SUITE 610 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731209350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057523962 | ||||||||
| FaxNumber: | 4057523963 | ||||||||
| Practice Location | |||||||||
| Address1: | 4300 W MEMORIAL RD | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731208304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057523962 | ||||||||
| FaxNumber: | 4057523963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 09/03/2015 | ||||||||
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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 | 207R00000X | 9406745 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 0434399 | KS | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 31726 | OK | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 31726 | OK | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.