Provider Demographics
NPI:1710948831
Name:DAKIL, SAMUEL EDWARD II (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:EDWARD
Last Name:DAKIL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:S.
Other - Middle Name:EDWARD
Other - Last Name:DAKIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:500 E ROBINSON ST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6697
Mailing Address - Country:US
Mailing Address - Phone:405-360-9966
Mailing Address - Fax:405-360-9905
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-360-9966
Practice Address - Fax:405-360-9905
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14289208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731303042001OtherBLUE CROSS BLUE SHIELD
OK100124080AMedicaid
OK731303042001OtherBLUE CROSS BLUE SHIELD