Provider Demographics
NPI:1619969409
Name:DOW, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:DOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-945-4886
Mailing Address - Fax:
Practice Address - Street 1:700 NW 24TH AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6400
Practice Address - Country:US
Practice Address - Phone:405-573-5410
Practice Address - Fax:405-573-5446
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK172352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4234662OtherAETNA EDI
OK100105440AMedicaid
OK130007357OtherRAILROAD MEDICARE
OK100105440AMedicaid