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Organization

NORTHERN OKLAHOMA DERMATOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS ALBERT MIETUS PA (PRESIDENT/ OWNER)
(405) 205-7072
Entity
Organization

Contact information

Practice address
309 SE FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74003-3643
(918) 214-8888
(918) 214-8887
Mailing address
309 SE FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74003-3643
(918) 214-8888
(918) 214-8887

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
08/28/2023
Last updated
05/08/2024
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