Individual
DR. MARK EDWARD MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1505 N COMMERCE ST, SUITE #204, ARDMORE, OK 73401-1863
(580) 226-3003
(580) 798-3124
Mailing address
1505 N COMMERCE ST, SUITE #204, ARDMORE, OK 73401-1863
(580) 226-3003
(580) 798-3124
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2962
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100130510B
—
OK
01
—
P00300469
RAILROAD MEDICARE PART B
OK
Enumeration date
05/02/2006
Last updated
09/16/2016
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