Healthcare Provider Details

I. General information

NPI: 1801006614
Provider Name (Legal Business Name): DARLENE K FOSTER MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 NW 56TH ST SUITE 604
OKLAHOMA CITY OK
73112-4479
US

IV. Provider business mailing address

3330 NW 56TH ST SUITE 604
OKLAHOMA CITY OK
73112-4479
US

V. Phone/Fax

Practice location:
  • Phone: 405-951-5992
  • Fax: 405-292-5505
Mailing address:
  • Phone: 405-951-5992
  • Fax: 405-292-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18470
License Number StateOK

VIII. Authorized Official

Name: DARLENE K FOSTER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 405-951-5992