Individual
MICHAEL J DAVOLI II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1651 PROFESSIONAL CIRCLE, YUKON, OK 73099
(405) 350-6770
(405) 350-6768
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 350-6770
(405) 350-6768
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
23194
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200005660A
—
OK
Enumeration date
01/03/2006
Last updated
06/26/2017
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