Individual
DR. GWEN CANARIAS FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
919 15TH AVE NW, ARDMORE, OK 73401-1809
(580) 223-5693
(580) 223-8909
Mailing address
919 15TH AVE NW, ARDMORE, OK 73401-1809
(580) 223-5693
(580) 223-8909
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13171
OK
Other
Enumeration date
06/30/2005
Last updated
07/09/2007
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