Individual
WELDON TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4401 SW 44TH ST, OKLAHOMA CITY, OK 73119-2899
(405) 636-7195
Mailing address
4401 SW 44TH ST, OKLAHOMA CITY, OK 73119-2899
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0054
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054
RESIDENT IN TRAINING
OK
Enumeration date
07/23/2014
Last updated
07/23/2014
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