Individual
DR. MATTHEW TYLER GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-3677
Mailing address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(402) 271-3677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2018015583
MO
2086S0120X
Pediatric Surgery Physician
2018015583
MO
Other
Enumeration date
06/14/2016
Last updated
08/13/2026
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