Individual
DR. NATHAN WILSON UY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
(918) 505-3225
Mailing address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
(918) 505-3225
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0431073
KS
2085R0001X
Radiation Oncology Physician
Primary
24231
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20004400A
—
OK
05
—
200750650A
—
OK
01
—
24231
MEDICAL LICENSURE
OK
Enumeration date
10/18/2005
Last updated
04/17/2020
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