Individual
DR. MARK DAVID CALLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7600 S LEWIS AVE, TULSA, OK 74136-6836
(539) 399-3410
Mailing address
7600 S LEWIS AVE, TULSA, OK 74136-6836
(539) 399-3410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4179
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200037760A
—
OK
Enumeration date
12/19/2005
Last updated
05/13/2024
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