Individual
DEENA DAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1202 SW 67TH STR, SUITE 2 AND 3, LAWTON, OK 73505
(580) 250-0324
(580) 248-4523
Mailing address
1202 S.W 67TH STR., SUITE 2 AND 3, LAWTON, OK 73505
(580) 250-0324
(580) 248-4523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14395
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100084210A
—
OK
Enumeration date
09/22/2005
Last updated
06/03/2009
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