Individual
BOBBY DON PRIDDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN CNP
Contact information
Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 218-8963
Mailing address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 218-8963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0092060
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200870040A
—
OK
Enumeration date
03/23/2018
Last updated
06/16/2025
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