Individual
MRS. KAMMIE MARIE CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2109 S HIGHWAY 69, WAGONER, OK 74467-9310
(918) 485-6069
(888) 815-0475
Mailing address
1202 W CHEROKEE ST STE D, WAGONER, OK 74467-4629
(918) 485-2104
(888) 815-0475
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24211
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049030B
—
OK
Enumeration date
01/11/2006
Last updated
10/06/2023
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