Individual
DR. GREGGORY JON WOITTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3130
(918) 458-3315
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3130
(918) 458-3315
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-105613
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
23702
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152094001
—
AK
05
—
200015060A
—
OK
Enumeration date
10/31/2005
Last updated
01/06/2011
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