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Individual

ETHAN A DOERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 341-7009
(405) 330-1811
Mailing address
1919 E MEMORIAL RD, OKLAHOMA CITY, OK 73131-1253
(405) 341-7009
(405) 330-1811

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
203758
OK
363LF0000X
Family Nurse Practitioner
Primary
203758
OK

Other

Enumeration date
11/06/2024
Last updated
05/21/2025
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