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General NPI Number Information
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NPI Number | 1215259882
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Entity Type | Organization
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Legal Business Name | MICHAEL H.MOWDY D.O INC
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Dates
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Enumeration Date | 02/23/2010
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 2149 SW 59TH ST SUITE 203
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-7033
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Country | US
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Telephone | 405-685-0919
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Fax | 405-686-7618
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Provider Business Mailing Address
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Address Line | 2149 SW 59TH ST SUITE 203
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City | OKLAHOMA CITY
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State | OK
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Zip | 73119-7033
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Country | US
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Telephone | 405-685-0919
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Fax | 405-686-7618
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Authorized Official
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Title or Position | CORP/PRESIDENT
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Name | DR. MICHAEL H MOWDY
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Credential | D.O.
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Telephone | 405-685-0919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 1876
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License Number State | OK
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