Individual
NATHAN MAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(501) 733-1089
Mailing address
915 E MARKET AVE, SEARCY, AR 72149-5615
(501) 279-5642
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4561
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2019
Last updated
05/10/2021
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