Healthcare Provider Details

I. General information

NPI: 1093868259
Provider Name (Legal Business Name): DALE GENE CLAFLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 NE 23RD ST
OKLAHOMA CITY OK
73105-7936
US

IV. Provider business mailing address

7500 BRENDA CIR
NORMAN OK
73026-4519
US

V. Phone/Fax

Practice location:
  • Phone: 405-425-4486
  • Fax: 405-419-4250
Mailing address:
  • Phone: 405-613-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number19980
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: