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Individual

JAMES BERRY WISE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3435 NW 56TH ST, STE #1010 A, OKLAHOMA CITY, OK 73112-4442
(405) 945-4747
(405) 945-4748
Mailing address
3435 NW 56TH ST, STE #1010 A, OKLAHOMA CITY, OK 73112-4442
(405) 945-4747
(405) 945-4748

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
8282
OK
207W00000X
Ophthalmology Physician
AW2160024
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8282
STATE LICENSE
OK
Enumeration date
01/30/2006
Last updated
03/07/2023
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