Individual
MARK T. GODISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13313 N MERIDIAN AVE, BUILDING D, OKLAHOMA CITY, OK 73120-8380
(405) 755-4290
(405) 755-7773
Mailing address
4401 W MEMORIAL RD, SUITE 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1350-TEP
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
28468
OK
207RP1001X
Pulmonary Disease Physician
Primary
28468
OK
Other
Enumeration date
05/03/2006
Last updated
05/20/2014
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