Individual
RAPHA WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12455 E 100TH ST N STE 350, OWASSO, OK 74055-4675
(918) 274-5510
(918) 403-6312
Mailing address
12455 E 100TH ST N STE 350, OWASSO, OK 74055-4675
(918) 274-5510
(918) 403-6312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28492
OK
Other
Enumeration date
06/06/2011
Last updated
09/26/2019
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