Provider Demographics
NPI:1760772008
Name:DEAKINS, DENNIS EUGENE (MD MPH PHD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EUGENE
Last Name:DEAKINS
Suffix:
Gender:M
Credentials:MD MPH PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63800 E 300 RD
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-7991
Mailing Address - Country:US
Mailing Address - Phone:918-786-4179
Mailing Address - Fax:918-786-4179
Practice Address - Street 1:63800 E 300 RD
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7991
Practice Address - Country:US
Practice Address - Phone:918-786-4179
Practice Address - Fax:918-786-4179
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10867174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist