Provider Demographics
NPI:1942458773
Name:DARE, KEVIN DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DAVID
Last Name:DARE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1145 S UTICA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:918-579-1262
Practice Address - Street 1:1809 E 13TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4431
Practice Address - Country:US
Practice Address - Phone:918-579-3825
Practice Address - Fax:918-579-1262
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2021-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK4511208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery