Organization
ADULT MEDICINE SPECIALIST OF CANADIAN VALLEY, P.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN D HYDE MO (PROVIDER/OWNER)
(405) 354-2118
Entity
Organization
Contact information
Practice address
1608 PROFESSIONAL CIRCLE, YUKON, OK 73099
(405) 354-2118
(405) 354-1380
Mailing address
PO BOX 851100, DEPT 200, YUKON, OK 73085
(405) 354-2118
(405) 354-1380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
OK
Other
Enumeration date
08/01/2005
Last updated
07/21/2022
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