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Individual

PHILLIP G DOERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3100 SW 89TH ST, OKLAHOMA CITY, OK 73159-7900
(405) 602-8100
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14750
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100827590A
OK
Enumeration date
03/24/2006
Last updated
07/28/2017
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