Provider Demographics
NPI:1326467499
Name:GARRISON, DANIEL MOSES (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MOSES
Last Name:GARRISON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 NW HEATHERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9536
Mailing Address - Country:US
Mailing Address - Phone:405-517-6539
Mailing Address - Fax:
Practice Address - Street 1:3414 NW CACHE RD STE F
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3878
Practice Address - Country:US
Practice Address - Phone:405-517-6539
Practice Address - Fax:580-265-8849
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6306207Q00000X, 207Q00000X
ND14968207Q00000X
TXR6399207Q00000X
ARE-11346207Q00000X
LA308726207Q00000X
CA17277207Q00000X
NE1358207Q00000X
OK6169208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery