Individual
DR. DEREK JAMES POURTORKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2916 N KELLY AVE, EDMOND, OK 73003-3233
(405) 715-5300
(405) 715-5350
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 713-5300
(405) 715-5350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6732
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/06/2018
Last updated
07/23/2021
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