Organization
BEAUTY THRU HEALTH DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE LAPIERCE WILEY SR. M.D. (PRESIDENT)
(405) 278-7911
Entity
Organization
Contact information
Practice address
1211 N SHARTEL AVE STE 407, OKLAHOMA CITY, OK 73103-2425
(405) 278-7911
(405) 278-7925
Mailing address
PO BOX 2074, LOWELL, AR 72745-2074
(405) 278-7911
(405) 278-7925
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12980
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300522112
MEDICARE PTAN
OK
Enumeration date
05/17/2007
Last updated
08/04/2016
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