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NPI Code Detail

MEDICARE: DANIEL DEAN WASHBURN MD

MEDICARE: DANIEL DEAN WASHBURN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician11337OK
2207R00000XInternal Medicine Physician11337OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01284450OTHEROKRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013901461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL DEAN WASHBURN MD
Provider Business Mailing Address
First Line : PO BOX 3046
Second Line :
City : MALVERN
State : PA
Zip : 19355-0746
Country : US
Telephone Number : 580-242-3090
Fax Number :
Provider Business Practice Location Address
First Line : 615 E OKLAHOMA AVE STE 208
Second Line :
City : ENID
State : OK
Zip : 73701-5952
Country : US
Telephone Number : 580-242-3090
Fax Number : 580-234-2090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 08/19/2019

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Directions to “ DANIEL DEAN WASHBURN MD” Practice Location

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