Individual
BEVERLY DOTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
722 SMALLEY DR, NORMAN, OK 73071-4107
(405) 364-1194
Mailing address
722 SMALLEY DR, NORMAN, OK 73071-4107
(405) 364-1194
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
M082539356
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200020350A
SOONER CARE
OK
Enumeration date
07/02/2014
Last updated
07/02/2014
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