Individual
DR. REUBIN MORRIS WIGDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
120 N FORREST, STRATFORD, OK 74872-4652
(580) 436-7048
(580) 759-2174
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-2451
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
516
OK
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100632190A
—
OK
05
—
100632190B
—
OK
Enumeration date
12/12/2006
Last updated
07/10/2020
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