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General NPI Number Information
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NPI Number | 1376516757
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Entity Type | Individual
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Provider Name | KATIE BETH DALTON DO
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 7723 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74133-6053
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Country | US
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Telephone | 918-895-7808
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Fax | 918-895-7807
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Provider Business Mailing Address
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Address Line | 6528 E 101ST ST PMB 431 SUITE D1
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City | TULSA
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State | OK
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Zip | 74133-6724
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Country | US
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Telephone | 918-895-7808
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Fax | 918-895-7807
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4061
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License Number State | OK
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