Provider Demographics
NPI:1033392188
Name:MARK OATMAN MD PLLC
Entity Type:Organization
Organization Name:MARK OATMAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:OATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-765-1777
Mailing Address - Street 1:215 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-4335
Mailing Address - Country:US
Mailing Address - Phone:580-762-1777
Mailing Address - Fax:580-762-1771
Practice Address - Street 1:215 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-4335
Practice Address - Country:US
Practice Address - Phone:580-762-1777
Practice Address - Fax:580-762-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty