Wyatt, Willie G.

Wyatt, Willie G. is an individual health care provider with primary practice located at 5720 W Memorial Rd , Oklahoma City OK 73142-2010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wyatt, Willie G. can be contacted via phone (405) 470-7100.

Contact Information

Primary practice address
5720 W Memorial Rd Oklahoma City OK 73142-2010
Phone: (405) 470-7100
Fax: (405) 470-7111
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9068 Oklahoma

Profile Details

NPI number 1538199443
LBN Legal business name Wyatt, Willie G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Oct 4th, 2018 - about 7 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 1538199443 NPPES
Oklahoma Other 9068 LICENSE
Oklahoma MEDICAID 100116560B LICENSE

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