Individual
MICHAEL DEAN WITHROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 FAIRVIEW AVE, SUITE 50, PONCA CITY, OK 74601-1920
(580) 762-0695
Mailing address
26 HILLCREST DR., PONCA CITY, OK 74604
(580) 304-3881
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0054495
OK
Other
Enumeration date
10/03/2006
Last updated
07/22/2009
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