Walther, Larry L

Walther, Larry L is an individual health care provider with primary practice located at 21 W Central Ave , Miami OK 74354-6815. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Walther, Larry L can be contacted via phone (918) 542-3900.

Contact Information

Primary practice address
21 W Central Ave Miami OK 74354-6815
Phone: (918) 542-3900
Fax: (918) 542-3928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 681 Oklahoma

Profile Details

NPI number 1609871987
LBN Legal business name Walther, Larry L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Feb 24th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609871987 NPPES
Oklahoma MEDICAID 100186200A
Oklahoma MEDICAID 200468380F

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