Individual
JONATHAN L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4221 S WESTERN AVE, STE 3010, OKLAHOMA CITY, OK 73109-3447
(405) 644-6232
(405) 644-5493
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 644-6232
(405) 644-5493
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
14691
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100051410A
—
OK
Enumeration date
06/15/2006
Last updated
11/15/2012
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