Individual
DR. JOHNATHAN PARKER TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5545
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5545
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9196
OK
Other
Enumeration date
05/15/2024
Last updated
08/08/2025
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