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Contact Information

KYLE A WILSON, DO
1725 E 19TH ST STE 401
TULSA, OK74104
 Phone: 918-749-1413
 Fax: 918-749-0234
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for KYLE A WILSON · (Male)

NPI # 1841619905
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/15/2014
Last updated 07/11/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 5838
  • OK Medicaid 200664660A
  • OK Medicaid 200774440A
Hospital affiliation(s)
  • ST JOHN MEDICAL CENTER INC - (Acute Care)
    1923 SOUTH UTICA AVENUE
    TULSA, OK 74104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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