Individual
BENJAMIN BAKER FORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1005 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 223-4800
(580) 223-4801
Mailing address
1001 15TH AVE NW, ARDMORE, OK 73401
(580) 223-3737
(580) 223-4801
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
2273
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2273
OKLAHOMA LICENSE
OK
Enumeration date
04/18/2006
Last updated
04/15/2016
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