Individual
KEVIN PAUL MARCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23106 SW BISHOP RD, INDIAHOMA, OK 73552
(580) 284-4219
Mailing address
23106 SW BISHOP RD, INDIAHOMA, OK 73552
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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