MEDICARE: DR. MARK A OATMAN 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
1	207Q00000X	Family Medicine Physician	04-29587	KS
2	207Q00000X	Family Medicine Physician	26016	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1205814449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A OATMAN MD

Provider Business Mailing Address
First Line	:	154 S MCCORD RD
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74604-5885
Country	:	US
Telephone Number	:	580-747-9039
Fax Number	:

Provider Business Practice Location Address
First Line	:	154 S MCCORD RD
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74604-5885
Country	:	US
Telephone Number	:	580-747-9039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	09/25/2019

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