Provider Demographics
NPI:1083682595
Name:TEAGUE, DAVID C (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:TEAGUE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1122 NE 13TH ST
Mailing Address - Street 2:ORI274
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-2663
Mailing Address - Fax:405-271-6762
Practice Address - Street 1:825 NE 10TH ST
Practice Address - Street 2:OUPB1300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5417
Practice Address - Country:US
Practice Address - Phone:405-271-6663
Practice Address - Fax:405-271-6762
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2014-09-30
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Provider Licenses
StateLicense IDTaxonomies
OK16967207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery