Individual
MR. BILLY WAYNE THIBODEAUX III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
Mailing address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R0129852
OK
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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