Provider Demographics
NPI:1467278994
Name:DOAK, ANDREW MASON
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MASON
Last Name:DOAK
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 1:2646 S QUEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-4830
Mailing Address - Country:US
Mailing Address - Phone:303-915-7919
Mailing Address - Fax:
Practice Address - Street 1:2646 S QUEBEC AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-4830
Practice Address - Country:US
Practice Address - Phone:303-915-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program