Provider Demographics
NPI:1114772365
Name:DOZIER, DAVEON D
Entity type:Individual
Prefix:
First Name:DAVEON
Middle Name:D
Last Name:DOZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 SUNVALLEY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-1316
Mailing Address - Country:US
Mailing Address - Phone:405-219-4133
Mailing Address - Fax:
Practice Address - Street 1:1200 S AIR DEPOT BLVD STE O
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4848
Practice Address - Country:US
Practice Address - Phone:405-931-9811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist