Individual
DR. NICHOLAS TWIDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,PHD.
Contact information
Practice address
1701 W AVENUE A, ELK CITY, OK 73644-3901
(580) 225-6220
(580) 225-6399
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17189
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100103330A
—
OK
Enumeration date
03/24/2006
Last updated
06/06/2022
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