Individual
MR. PETER GEORGE WIPFLI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2825 PARKLAWN DR, MIDWEST CITY, OK 73110-4201
(405) 610-4411
Mailing address
PO BOX 10736, MIDWEST CITY, OK 73140-1736
(405) 769-9218
(405) 769-9218
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0022628
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
730927322002
BCBS
OK
01
—
730927322003
TRICARE
OK
Enumeration date
10/03/2005
Last updated
07/08/2007
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