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General NPI Number Information
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NPI Number | 1952377442
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Entity Type | Individual
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Provider Name | DARRELL ROBERT MEASE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 659 S. 14TH ST. BLDG. B
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City | JAY
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State | OK
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Zip | 74346
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Country | US
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Telephone | 918-253-6418
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Fax | 918-253-4066
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Provider Business Mailing Address
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Address Line | MEASE MEDICAL
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City | JAY
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State | OK
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Zip | 74346
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Country | US
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Telephone | 918-253-6418
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Fax | 918-253-4066
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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 | 16931
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License Number State | OK
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