SCOTT C WIXOM

TULSA, OK
NPI1780636407
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MO  2003026225)
Enumeration Date2006-05-17
Last Update Date2007-07-08
Business Address
-- SCOTT C WIXOM CRNA
1120 S UTICA AVE
TULSA, OK 74104-4012
Phone number: 918-728-4719
Mailing Address
-- SCOTT C WIXOM CRNA
12518 S CEDAR AVE
JENKS, OK 74037-4983
Phone number: 918-728-7419