Healthcare Provider Details

I. General information

NPI: 1609842806
Provider Name (Legal Business Name): JOHN DACHAUER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NE 10TH ST
OKLAHOMA CITY OK
73104-5403
US

IV. Provider business mailing address

701 NE 10TH ST
OKLAHOMA CITY OK
73104-5403
US

V. Phone/Fax

Practice location:
  • Phone: 405-280-5550
  • Fax:
Mailing address:
  • Phone: 405-280-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number15567
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: