Individual
KENNETH M EGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RR 1 BOX 3060, CLINTON, OK 73601-9303
(580) 323-2884
(580) 323-2579
Mailing address
215 S 28TH ST, APT # B-3, CLINTON, OK 73601-3609
(580) 323-2884
(580) 323-2579
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35050525E
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9135050
—
OK
Enumeration date
12/26/2006
Last updated
07/09/2007
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