Individual
JOEL NDIFORYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 755-4290
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
10/03/2023
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