Provider Demographics
NPI:1457701609
Name:DE GASTON, DAVID EVANS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EVANS
Last Name:DE GASTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-702-9400
Mailing Address - Fax:405-702-9437
Practice Address - Street 1:4801 SE 15TH ST STE 300
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3918
Practice Address - Country:US
Practice Address - Phone:405-702-9400
Practice Address - Fax:405-702-9437
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2019-06-27
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Provider Licenses
StateLicense IDTaxonomies
OK32239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine