Individual
DALE ARCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2410 N COMMERCE, ARDMORE, OK 73401
(580) 226-0812
(580) 226-0820
Mailing address
2410 N COMMERCE, ARDMORE, OK 73401
(580) 226-0812
(580) 226-0820
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
594
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200042080A
—
OK
Enumeration date
07/27/2006
Last updated
05/27/2020
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