MEDICARE: DR. DAVID WILLIAM BANK 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	9686	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
2	731085009001	OTHER		BCBS

General Provider Information

NPI Number	:	1396833083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WILLIAM BANK MD

Provider Business Mailing Address
First Line	:	1221 COLORADO
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644
Country	:	US
Telephone Number	:	580-225-4000
Fax Number	:	580-243-3408

Provider Business Practice Location Address
First Line	:	1221 COLORADO
Second Line	:
City	:	ELK CITY
State	:	OK
Zip	:	73644
Country	:	US
Telephone Number	:	580-225-4000
Fax Number	:	580-243-3408

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	11/17/2011

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