Individual
DR. ANDREW PAUL WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 STANTON L YOUNG BLVD, G. RAINEY WILLIAMS PAVILION - 3RD FLOOR, OKLAHOMA CITY, OK 73104-5036
(405) 271-4468
Mailing address
PO BOX 720006, NORMAN, OK 73070-4006
(405) 533-8612
(405) 533-8623
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
32267
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2016
Last updated
09/02/2020
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