Organization
DAVID D ROSE, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID D ROSE MD (OWNER)
(580) 223-5400
Entity
Organization
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-5400
Mailing address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 223-5400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7472
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487618815
INDIVIDUAL NPI #
OK
01
—
7472
OK7472
OK
Enumeration date
08/29/2006
Last updated
08/22/2020
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