Provider Demographics
NPI:1164447694
Name:BEHM, DAVID W (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:BEHM
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Gender:M
Credentials:DO
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Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-751-4664
Mailing Address - Fax:405-749-4561
Practice Address - Street 1:5602 SW LEE BLVD
Practice Address - Street 2:ER DEPT
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9635
Practice Address - Country:US
Practice Address - Phone:580-531-4700
Practice Address - Fax:405-749-4561
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OK2685207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00013682OtherRR MEDICARE
OKP00013682OtherRR MEDICARE