Individual
HUMBERTO VIDAILLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
940 NE 13TH ST, 1B1409, OKLAHOMA CITY, OK 73104-5008
(405) 271-8685
Mailing address
1122 NE 13TH ST, ORI 236, OKLAHOMA CITY, OK 73117-1039
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9422
OK
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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