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1780636407
SCOTT C WIXOM
TULSA, OK
NPI
1780636407
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MO 2003026225)
Enumeration Date
2006-05-17
Last Update Date
2007-07-08
Business Address
-- SCOTT C WIXOM CRNA
1120 S UTICA AVE
TULSA, OK 74104-4012
Phone number: 918-728-4719
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Mailing Address
-- SCOTT C WIXOM CRNA
12518 S CEDAR AVE
JENKS, OK 74037-4983
Phone number: 918-728-7419
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