Individual
DR. KYLE ANDREW WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1725 E 19TH ST STE 401, TULSA, OK 74104
(918) 749-1413
(918) 749-0234
Mailing address
1725 E 19TH ST STE 401, TULSA, OK 74104-5409
(918) 749-1413
(918) 749-0234
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5838
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200664660A
—
OK
05
—
200774440A
—
OK
Enumeration date
04/15/2014
Last updated
07/11/2022
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