Individual
HEATH BRANDON WELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
13616 E 103RD ST N, STE A, OWASSO, OK 74055-4586
(918) 274-8555
(918) 274-8556
Mailing address
13616 E 103RD ST N, STE A, OWASSO, OK 74055-4586
(918) 274-8555
(918) 274-8556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1829
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200243070A
—
OK
Enumeration date
05/11/2009
Last updated
07/09/2009
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