Organization
OKLAHOMA KIDNEY CARE DIALYSIS, LLC
Active
Organization
OKLAHOMA KIDNEY CARE DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORRAINE T WILSON M.D. (MEMBER PRESIDENT)
(405) 748-5800
Entity
Organization
Contact information
Practice address
13901 MCAULEY BLVD, OKLAHOMA CITY, OK 73134-8700
(405) 748-5800
(405) 748-5806
Mailing address
13901 MCAULEY BLVD, OKLAHOMA CITY, OK 73134-8700
(405) 748-5812
(405) 748-5818
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2008
Last updated
05/01/2009
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