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Individual

DR. DANIEL STUDDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
10507 E 91ST ST, SUITE 550, TULSA, OK 74133-5589
(918) 307-3060
(918) 307-3061
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2651
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100072170A
OK
01
700522067
MEDICARE GROUP PIN
OK
Enumeration date
04/13/2006
Last updated
04/24/2012
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