MEDICARE: DR. DAVID K ESLICKER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	2149	OK

General Provider Information

NPI Number	:	1265419691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID K ESLICKER D.O.

Provider Business Mailing Address
First Line	:	501 SE FRANK PHILLIPS BLVD
Second Line	:	SUITE 202
City	:	BARTLESVILLE
State	:	OK
Zip	:	74003-3913
Country	:	US
Telephone Number	:	918-336-5454
Fax Number	:	918-336-4449

Provider Business Practice Location Address
First Line	:	501 SE FRANK PHILLIPS BLVD
Second Line	:	SUITE 202
City	:	BARTLESVILLE
State	:	OK
Zip	:	74003-3913
Country	:	US
Telephone Number	:	918-336-5454
Fax Number	:	918-336-4449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	07/08/2007

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