Individual
MR. DERRICK HIGHTOWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2525 NW EXPRESSWAY, SUITE 624A, OKLAHOMA CITY, OK 73112-7227
(405) 242-5070
(405) 242-5071
Mailing address
1309 NW 106TH ST, OKLAHOMA CITY, OK 73114-5209
(405) 476-2688
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
103K00000X
OK
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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