Individual
MARK MATTHEW MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 NE 10TH ST STE 4C, OKLAHOMA CITY, OK 73104-5417
(405) 271-1368
Mailing address
800 STANTON L YOUNG BLVD # 1400, OKLAHOMA CITY, OK 73104-5018
(210) 241-6275
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
35702
OK
Other
Enumeration date
03/31/2014
Last updated
03/16/2022
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