Individual
ERIC MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5545
Mailing address
2403 W MAIN ST, HENRYETTA, OK 74437-3893
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7011
OK
Other
Enumeration date
04/11/2019
Last updated
09/21/2022
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