Provider Information for 1770140055
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Mr. SKYLER JAMES WORLEY MS
Sex: Male
NPI: 1770140055
Last Updated: 2021-10-28
Certification Date: 2021-10-28
Certification Date: 2021-10-28
Details
Name | Value | ||||||||||||
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NPI | 1770140055 | ||||||||||||
Enumeration Date | 2019-05-22 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 58150 E 66 RD MIAMI, OK 74354-6509 United States Phone: 918-542-1786 | Fax:918-238-3331 | ||||||||||||
Primary Practice Address | 405 E EXCELSIOR AVE VINITA, OK 74301-4226 United States Phone: 918-256-6476 | Fax:918-256-3628 | ||||||||||||
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