Individual
JAMES A. WALTERMIRE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 W 6TH AVE, SUITE 202, STILLWATER, OK 74074-4375
(405) 743-0550
(405) 743-1704
Mailing address
1301 W 6TH AVE, SUITE 202, STILLWATER, OK 74074-4375
(405) 743-0550
(405) 743-1704
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
9285
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A002
CHAMPUS
OK
Enumeration date
11/21/2005
Last updated
07/09/2007
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