Healthcare Provider Details

I. General information

NPI: 1972124857
Provider Name (Legal Business Name): DAVID MIGUEL SOTO MEDICAL SCHOOL (MD)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 N MAY AVE
OKLAHOMA CITY OK
73120-4417
US

IV. Provider business mailing address

9100 N MAY AVE
OKLAHOMA CITY OK
73120-4417
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-4456
  • Fax: 405-840-4295
Mailing address:
  • Phone: 405-840-4456
  • Fax: 405-840-4295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41655
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: