Individual
DR. KENNETH TED DARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1102 W MACARTHUR ST, SHAWNEE, OK 74804-1743
(405) 878-8110
(405) 878-8101
Mailing address
1102 W MACARTHUR ST, SHAWNEE, OK 74804-1743
(405) 878-8110
(405) 878-8101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20274
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100063060A
—
OK
Enumeration date
02/09/2006
Last updated
10/20/2014
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