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Organization
DARYL E. BIRDWELL, M.D., INC.
Active
Organization
DARYL E. BIRDWELL, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANNA SIMMONS (OFFICE MANAGER)
(580) 248-7417
Entity
Organization
Contact information
Practice address
4417 W GORE BLVD STE 2, LAWTON, OK 73505-5978
(580) 248-7417
(580) 248-4847
Mailing address
4417 W GORE BLVD STE 2, LAWTON, OK 73505-5978
(580) 248-7417
(580) 248-4847
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10548OK
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094050A
—
OK
01
—
10548OK
STATE LIC.
OK
Enumeration date
03/01/2007
Last updated
09/22/2010
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