Wolf, Mitchell A

Wolf, Mitchell A is an individual health care provider with primary practice located at 3214 Kethley Rd , Shawnee OK 74804-9625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wolf, Mitchell A can be contacted via phone (405) 273-5801.

Contact Information

Primary practice address
3214 Kethley Rd Shawnee OK 74804-9625
Phone: (405) 273-5801
Fax: (405) 878-3794
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10580 Nevada
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 18589 Oklahoma

Profile Details

NPI number 1174608319
LBN Legal business name Wolf, Mitchell A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Nov 11th, 2016 - about 8 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 1174608319 NPPES
Nevada Other P00366183 RAILROAD MEDICARE
Nevada MEDICAID 100506264 RAILROAD MEDICARE

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