Individual
KELLY MARAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O., M.S.
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Mailing address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5679
OK
390200000X
Student in an Organized Health Care Education/Training Program
240394
MA
Other
Enumeration date
06/14/2009
Last updated
04/24/2020
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