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Individual

DR. WILEY G DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5002 SW LEE BOULEVARD, LAWTON, OK 73505-8320
(580) 531-4512
(580) 531-4519
Mailing address
5002 SW LEE BOULEVARD, LAWTON, OK 73505-8320
(580) 531-4512
(580) 531-4519

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
12320
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15560
BNDD
OK
01
AD8776099
U.S. DEPT OF JUSTICE
Enumeration date
08/15/2006
Last updated
03/07/2023
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