Individual
WADE MATHERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
300 W NORTH ST, SEDAN, KS 67361-1051
(620) 725-3115
Mailing address
1705 E 19TH ST, STE 302, TULSA, OK 74104-5410
(918) 645-3612
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
KS
Other
Enumeration date
08/10/2014
Last updated
04/24/2020
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