Individual
DR. MITSI A FAUBION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
109 STANLEY RD, CLAYTON, OK 74536-0219
(918) 569-4143
(918) 569-7343
Mailing address
PO BOX 67, MILBURN, OK 73450-0067
(580) 443-3533
(580) 443-3536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4294
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200072150B
—
OK
Enumeration date
09/20/2005
Last updated
10/18/2016
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