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Individual

MR. DANIEL J OETKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
2929 S GARNETT RD, TULSA, OK 74129-5101
(918) 665-1520
(918) 663-8434
Mailing address
2929 SOUTH GARNETT, TULSA, OK 74129-5101
(918) 665-1520
(918) 663-8434

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1770
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200219930A
OK
Enumeration date
08/10/2006
Last updated
07/28/2010
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