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Organization
GRACE DPC
Active
Organization
GRACE DPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKI LEWIS-WYATT PA-C (PRESIDENT)
(580) 307-6263
Entity
Organization
Contact information
Practice address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602
Mailing address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/12/2025
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