Individual
JANET FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
416 SW 79TH ST STE 100, OKLAHOMA CITY, OK 73139-8121
(405) 702-4777
(405) 702-4770
Mailing address
416 SW 79TH ST STE 100, OKLAHOMA CITY, OK 73139-8121
(405) 702-4777
(405) 702-4770
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17606
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100195030B
—
OK
Enumeration date
06/09/2006
Last updated
11/30/2018
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