Individual
DR. DAVID BRENT ROTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, FACOS
Contact information
Practice address
1500 E. DOWNING, #103, TAHLEQUAH, OK 74464
(918) 207-1140
(918) 207-0335
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 207-1410
(918) 207-0335
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
118997
MO
208600000X
Surgery Physician
3315
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020043303
MEDICARE RAILROAD
MO
05
—
100102820A
—
OK
05
—
244688909
—
MO
01
—
CF9170
MEDICARE RAILROAD
MO
Enumeration date
05/05/2006
Last updated
05/18/2010
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