Individual
MR. KELLEN WILLIAM JOSEPH HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1201 HEALTH CENTER PKWY, YUKON, OK 73099-6381
(405) 717-6800
Mailing address
9005 SW 38TH TER, OKLAHOMA CITY, OK 73179-3813
(740) 296-4763
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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