Wooderson, Kyle C
Wooderson, Kyle C is an individual health care provider with primary practice located at 601 E 13Th St Ste H, Grove OK 74344-2989. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wooderson, Kyle C can be contacted via phone (918) 786-7300.Contact Information
Primary practice address
601 E 13Th St Ste H
Grove OK 74344-2989
Phone: (918) 786-7300
Fax: (918) 786-7303
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4824 | Oklahoma |
Profile Details
| NPI number | 1508095977 |
|---|---|
| LBN Legal business name | Wooderson, Kyle C |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2009 |
| Last updated | Apr 5th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508095977 | NPPES |
| Oklahoma | MEDICAID | 200254780A | |
| Oklahoma | MEDICAID | 200505990O |
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