Individual
DALE EDWIN DAUTENHAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9423 E 95TH CT, TULSA, OK 74133-5805
(918) 496-2400
(405) 948-6507
Mailing address
DEPT 1654, TULSA, OK 74182-0001
(405) 947-8585
(405) 948-6507
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16586
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111210C
—
OK
01
—
2769256
CIGNA
OK
Enumeration date
09/16/2005
Last updated
04/18/2008
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