Individual
VITALIY KRYLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 E 13TH ST STE C, GROVE, OK 74344-2962
(918) 786-7878
(918) 786-7884
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(918) 786-7878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31727
OK
390200000X
Student in an Organized Health Care Education/Training Program
31727
OK
Other
Enumeration date
06/29/2015
Last updated
09/14/2020
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