Organization
DR.MICKEY TYRRELL, M.D. PLLC
Active
Other names
Hornet Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICKEY RAY TYRRELL MD (OWNER)
(918) 256-2261
Entity
Organization
Contact information
Practice address
803 N FOREMAN ST, SUITE 102, VINITA, OK 74301-1412
(918) 256-2261
(918) 256-2304
Mailing address
803 N FOREMAN ST, SUITE 102, VINITA, OK 74301-1412
(918) 256-2261
(918) 256-2304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22897
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200067580A
—
OK
Enumeration date
06/29/2007
Last updated
09/01/2016
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