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Individual

PETER FAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2900 N MAIN ST STE 101, MUSKOGEE, OK 74401-4078
(918) 684-2663
(918) 681-6804
Mailing address
6600 S YALE AVE STE 1200, TULSA, OK 74136-3333
(918) 488-6687
(918) 488-6098

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29225
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
29225
OK

Other

Enumeration date
04/25/2012
Last updated
03/28/2018
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