Provider Demographics
NPI:1154755619
Name:WEST, DAVID PARKER (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PARKER
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:404 STEVE DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4756
Mailing Address - Country:US
Mailing Address - Phone:405-348-6551
Mailing Address - Fax:405-348-6551
Practice Address - Street 1:404 STEVE DOUGLAS DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-4756
Practice Address - Country:US
Practice Address - Phone:405-348-6551
Practice Address - Fax:405-348-6551
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2014-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK8513208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK8513OtherSTATE LICENSE TO PRACTICE MEDICINE
OK110-8513Medicaid
OK110-8513Medicaid