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General NPI Number Information
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NPI Number | 1275783623
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Entity Type | Organization
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Legal Business Name | DANIEL CONSTANCE, M.D. PLLC
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 5606 SW LEE BLVD SUITE 203
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-536-1111
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Fax | 580-536-2211
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Provider Business Mailing Address
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Address Line | 5606 SW LEE BLVD SUITE 203
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-536-1111
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Fax | 580-536-2211
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DANIEL CONSTANCE
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Credential | MD
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Telephone | 580-536-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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