Organization
WACHITA KIDNEY AND HYPERTENSION SPECIALISTS PLLC
Active
Organization
WACHITA KIDNEY AND HYPERTENSION SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAPHAEL LOUTOBY MD (CEO)
(580) 357-1002
Entity
Organization
Contact information
Practice address
4417 W GORE BLVD STE 3, LAWTON, OK 73505-5978
(580) 357-1002
Mailing address
PO BOX 7227, LAWTON, OK 73506-1227
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25397
OK
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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