Individual
ERIC WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 NW 31ST ST, LAWTON, OK 73505-6100
(580) 536-2121
(580) 250-5183
Mailing address
104 NW 31ST ST, LAWTON, OK 73505-6100
(580) 536-2121
(580) 250-5183
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
19537
OK
Other
Enumeration date
01/12/2007
Last updated
09/09/2018
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