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Individual

DR. SCOTT ALLEN DEMPEWOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2002 12TH AVE NW, ARDMORE, OK 73401-1206
(580) 226-8646
(580) 226-8641
Mailing address
2002 12TH AVE NW, ARDMORE, OK 73401-1206
(580) 226-8646
(580) 226-8641

Taxonomy

Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
20353
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040012718
MEDICARE RAILROAD
OK
05
100119370A
OK
Enumeration date
11/14/2005
Last updated
11/29/2011
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