MEDICARE: MARK A DAWKINS MD PC

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	207N00000X	Dermatology Physician
2	174400000X	Specialist	19539	OK

General Provider Information

NPI Number	:	1710198569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK A DAWKINS MD PC

Provider Business Mailing Address
First Line	:	DEPT 96-0317
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73196-0317
Country	:	US
Telephone Number	:	405-521-1969
Fax Number	:	405-521-1979

Provider Business Practice Location Address
First Line	:	13174 N MACARTHUR BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-3017
Country	:	US
Telephone Number	:	405-721-5555
Fax Number	:	405-470-7093

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	MARK A DAWKINS
Credential	:	M.D.
Telephone Number	:	405-721-5555

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	01/03/2019

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