Individual
MARK DAMON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6658
(580) 220-6673
Mailing address
4401 W MEMORIAL RD, 140, OKLAHOMA CITY, OK 73134-1785
(405) 762-3162
(405) 396-5211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
04752
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200250290A
—
OK
Enumeration date
07/01/2009
Last updated
04/28/2014
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