Individual
DALE WAYNE TITSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4140 W MEMORIAL RD STE 518, OKLAHOMA CITY, OK 73120-8300
(405) 749-4230
Mailing address
1501 NE 6TH ST, MOORE, OK 73160-7937
(405) 496-4783
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
219785
OK
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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