Individual
MR. GEORGE CLAYTON IDLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4130 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5209
(405) 857-5322
Mailing address
505 SW 3RD ST, TUTTLE, OK 73089-8934
(405) 857-5322
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
11/09/2023
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