Individual
DR. JOSHUA PRIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
905 COLONY DR, ADA, OK 74820-2329
(580) 436-5111
(580) 436-1159
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5800
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
5800
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5800
OK STATE BOARD OF OSTEOPATHIC EXAMINERS
OK
Enumeration date
06/25/2014
Last updated
11/18/2021
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