Provider Demographics
NPI:1518960756
Name:WOOSTER, DANIEL K (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:K
Last Name:WOOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:888-247-0125
Mailing Address - Fax:918-502-8210
Practice Address - Street 1:2950 S ELM PL STE 160
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7816
Practice Address - Country:US
Practice Address - Phone:918-455-7777
Practice Address - Fax:918-455-8105
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK10034880AMedicaid
OK700522038Medicare PIN