Individual
WALTER JAY EXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1245 S UTICA AVE, TULSA, OK 74104-4214
(918) 560-3832
(918) 583-0423
Mailing address
1145 S UTICA AVE, SUITE 110, TULSA, OK 74104-4000
(918) 579-3825
(918) 579-1262
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10770
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094000A
—
OK
Enumeration date
05/16/2006
Last updated
05/04/2009
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