Individual
VICKI JOYCE CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1616 S BOULEVARD ST, SUITE B, EDMOND, OK 73013-5155
(405) 341-5691
(405) 348-7543
Mailing address
1616 S BOULEVARD ST, SUITE B, EDMOND, OK 73013-5155
(405) 341-5691
(405) 348-7543
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
14083
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200081600A
—
OK
Enumeration date
11/22/2006
Last updated
07/09/2007
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