Individual
MATTHEW BRYAN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
701 E MAIN ST, JENKS, OK 74037-4316
(918) 298-2264
(918) 298-0923
Mailing address
701 E MAIN ST, JENKS, OK 74037-4316
(918) 298-2264
(918) 298-0923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5211
OK
Other
Enumeration date
04/13/2011
Last updated
08/25/2014
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