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NPI Code Detail

MEDICARE: KEVIN C CONATSER DO

MEDICARE: KEVIN C CONATSER DO
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
1207Q00000XFamily Medicine Physician3562OK

General Provider Information

NPI Number : 1669450821
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN C CONATSER DO
Provider Business Mailing Address
First Line : 11601 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-5823
Country : US
Telephone Number : 405-691-5208
Fax Number : 405-378-0556
Provider Business Practice Location Address
First Line : 11601 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-5823
Country : US
Telephone Number : 405-691-5208
Fax Number : 405-378-0556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 12/10/2010

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Directions to “ KEVIN C CONATSER DO” Practice Location

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