Organization
SCUDERIA SPINALE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO LUIS VILLAMIL WISCOVITCH MD (PROVIDER)
(918) 813-3901
Entity
Organization
Contact information
Practice address
505 E MAIN ST, JENKS, OK 74037-4136
(918) 813-3901
(918) 209-4915
Mailing address
10710 S FIR PL, JENKS, OK 74037-3026
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
10/22/2021
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