Individual
MARK A DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4221 S WESTERN AVE, SUITE 3030, OKLAHOMA CITY, OK 73109-3447
(405) 636-7650
(405) 636-7743
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 636-7650
(405) 636-7743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12883
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059480A
—
OK
Enumeration date
05/02/2006
Last updated
07/19/2017
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