Healthcare Provider Details

I. General information

NPI: 1629402722
Provider Name (Legal Business Name): LITITIA G DOWE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TISHA D DOWE M.D.

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 2 BOX 500
SEILING OK
73663-2300
US

IV. Provider business mailing address

RR 2 BOX 500
SEILING OK
73663-2300
US

V. Phone/Fax

Practice location:
  • Phone: 580-922-5255
  • Fax: 580-922-3630
Mailing address:
  • Phone: 580-922-5255
  • Fax: 580-922-3630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number15690
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: