Individual
DR. DAVID MATOUSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 S 5TH ST STE 302, ENID, OK 73701-5862
(580) 234-3320
Mailing address
PO BOX 3494, ENID, OK 73702-3494
(580) 234-3320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089010A
—
OK
Enumeration date
10/12/2006
Last updated
10/15/2019
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