Individual
DR. CHRISTOPHER ROBERT WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4802 S. 109TH E. AVE, TUSLA, OK 74146
(918) 392-1513
(918) 392-1590
Mailing address
4802 S. 109TH E. AVE, TUSLA, OK 74146
(918) 392-1513
(918) 392-1590
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35.131283
OH
207X00000X
Orthopaedic Surgery Physician
Primary
37775
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200974040A
—
OK
Enumeration date
07/13/2012
Last updated
03/30/2023
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