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General NPI Number Information
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NPI Number | 1053914952
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Entity Type | Individual
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Provider Name | ASHLEY DIANE VO MD
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Gender | Female
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Dates
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Enumeration Date | 11/21/2020
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 900 NE 10TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5420
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Country | US
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Telephone | 405-271-4311
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 HEBRON CT
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City | YUKON
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State | OK
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Zip | 73099-9633
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Country | US
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Telephone | 405-641-0316
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39547
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License Number State | OK
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