Doctor Name: | JULIE B UTLEY |
NPI Number: | 1184802605 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 1713 |
Business Practice Address: | 4805 E Highway 37 Tuttle, OK - 730898791 |
Business Phone Number: | 4053819979 |
Business Fax Number: | 4053819130 |
Mailing Address: | 4805 E Highway 37, TUTTLE |
State: | OK |
Postal Code: | 730898791 |
Phone Number: | 4053819979 |
Fax Number: | 4053819130 |
NPI Enumeration Date: | 02/06/2008 |
NPI Last Update Date: | 05/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1713 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |