Individual
NATHAN BLAKE JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15318 N MAY AVE STE B, EDMOND, OK 73013-8864
(405) 970-8020
Mailing address
15318 N MAY AVE STE B, EDMOND, OK 73013-8864
(405) 970-8020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32942
OK
Other
Enumeration date
04/05/2017
Last updated
03/06/2023
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