KELLY VAN DAVIS

WAGONER, OK
NPI1871554139
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: OK  23418)
Additional Taxonomies207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
(Licence: OK  23418)
207RR0500X Internal Medicine, Rheumatology
(Licence: OK  23418)
Enumeration Date2006-03-28
Last Update Date2022-10-14
Business Address
KELLY VAN DAVIS M.D.
1202 W CHEROKEE ST STE H
WAGONER, OK 74467-4629
Phone number: 918-614-5533
Mailing Address
KELLY VAN DAVIS M.D.
10907 S KNOXVILLE AVE
TULSA, OK 74137-6624
Phone number: 918-978-5588