Organization
AT HOME DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC WYATT (OWNER)
(405) 694-8003
Entity
Organization
Contact information
Practice address
2816 LAMOND HILL AVE, EDMOND, OK 73034-6978
(405) 694-8003
Mailing address
2816 LAMOND HILL AVE, EDMOND, OK 73034-6978
(405) 694-8003
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
19537
OK
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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