Individual
BROOK ASHLEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6802 S OLYMPIA AVE W, 300, TULSA, OK 74132-1823
(918) 749-0762
(918) 744-4246
Mailing address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3344
(918) 505-3290
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2417
OK
363A00000X
Physician Assistant
Primary
2417
OK
Other
Enumeration date
11/25/2014
Last updated
03/30/2018
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