Organization
CHILDREN'S CLINIC, PLLC
Active
Other names
Dr. Jerry Whatley
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN HARDAWAY (GENERAL MANAGER)
(918) 687-4411
Entity
Organization
Contact information
Practice address
3101 CHANDLER RD STE 101, MUSKOGEE, OK 74403-4955
(918) 687-4411
(918) 687-4448
Mailing address
3101 CHANDLER RD STE 101, MUSKOGEE, OK 74403-4955
(918) 687-4411
(918) 687-4448
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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