Individual
DR. DWAYNE LEE JANZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
915 E GARRIOTT RD STE A, ENID, OK 73701-6153
(580) 977-1910
(580) 237-1925
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(580) 977-1910
(580) 237-1925
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1639
OK
207Q00000X
Family Medicine Physician
34426
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252020C
—
OK
Enumeration date
07/26/2006
Last updated
02/12/2018
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