Individual
TOD MCCORMICK DOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
921 NE 13TH, (111AC), OKLAHOMA CITY, OK 73104-5028
(405) 456-4635
Mailing address
921 NE 13TH ST, (111AC), OKLAHOMA CITY, OK 73104-5007
(405) 270-0501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
799
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33787
IEN
OK
Enumeration date
09/27/2006
Last updated
01/21/2009
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