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Individual

DR. MICHAEL HINES TOLLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
179133 N 2600 RD, WALTERS, OK 73572-3817
(580) 695-4793
(580) 252-1253
Mailing address
179133 N 2600 RD, WALTERS, OK 73572-3817
(580) 695-4793
(580) 252-1253

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
28274
CO
207P00000X
Emergency Medicine Physician
Primary
28274
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1282748
CO
Enumeration date
05/08/2006
Last updated
05/22/2024
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