Provider Demographics
NPI:1629565627
Name:HERRMANN, DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HERRMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W MORROW RD
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-6549
Mailing Address - Country:US
Mailing Address - Phone:918-245-1328
Mailing Address - Fax:918-403-6313
Practice Address - Street 1:402 W MORROW RD
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-6549
Practice Address - Country:US
Practice Address - Phone:918-245-1328
Practice Address - Fax:918-403-6313
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine