Individual
TED KASPAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601
(580) 763-3036
Mailing address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 763-3036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4834
OK
Other
Enumeration date
01/30/2007
Last updated
08/22/2018
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