Individual
JAY WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(361) 949-4976
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3834
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200097310A
—
OK
Enumeration date
05/06/2006
Last updated
10/26/2007
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