Individual
DR. NEIL B VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5547
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
029104
CT
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
30161
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200519970A
—
OK
Enumeration date
08/27/2006
Last updated
08/22/2022
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