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Individual

MATHEW J IVORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
(580) 255-0500
(580) 252-1684
Mailing address
2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
(580) 255-0500
(580) 252-1684

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20243
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500522018
OK
Enumeration date
06/23/2006
Last updated
04/11/2012
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