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Individual

DR. THEODORE MATT WARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
12200 RIVENDELL DR, OKLAHOMA CITY, OK 73170-4704
(405) 735-5677
Mailing address
12200 RIVENDELL DR, OKLAHOMA CITY, OK 73170-4704
(405) 735-5677

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3516
OK
207P00000X
Emergency Medicine Physician
37640
CO

Other

Enumeration date
08/30/2006
Last updated
12/11/2013
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