Doctor Name: | CYNTHIA KAY WILKETT |
NPI Number: | 1023291457 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 4586 |
Business Practice Address: | 1826 E 15th St # D Tulsa, OK - 741044636 |
Business Phone Number: | 9187322990 |
Business Fax Number: | |
Mailing Address: | 1826 E 15th St # D, TULSA |
State: | OK |
Postal Code: | 741044636 |
Phone Number: | 9187322990 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2007 |
NPI Last Update Date: | 04/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4586 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |