Individual
MARC J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 N MONTE VISTA ST, SUITE A, ADA, OK 74820-4675
(580) 310-9510
(580) 436-4447
Mailing address
530 N MONTE VISTA ST, SUITE A, ADA, OK 74820-4675
(580) 310-9510
(580) 436-4447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3540
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097410A
—
OK
Enumeration date
06/03/2006
Last updated
09/15/2020
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