Individual
DAN NEAL WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5721 NW 132ND ST, OKLAHOMA CITY, OK 73142-4437
(405) 557-1200
(405) 557-1977
Mailing address
5721 NW 132ND ST, OKLAHOMA CITY, OK 73142-4437
(405) 557-1200
(405) 557-1977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14804
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10019480B
—
OK
Enumeration date
03/23/2006
Last updated
01/29/2024
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