person
Kelly J Walworth, PAC
Medical Physician Assistant in Oklahoma City, Oklahoma
NPI 1376526756

Kelly J Walworth is a Medical Physician Assistant based in Oklahoma City, OK and is specialized in Medical. Kelly J Walworth practices in Oklahoma City, OK and has the professional credentials of PAC. The NPI Number for Kelly J Walworth is 1376526756 and holds a License No. 1460 (Oklahoma).

The current practice location address for Kelly J Walworth is 13174 N Macarthur Blvd, Oklahoma City, OK and can be reached out via phone at 405-721-5555 and via fax at 405-470-7093. You can also correspond with Kelly J Walworth through the mailing address at DEPT 96-0317, OKLAHOMA CITY, OK - 73196-0317 (mailing address contact number: 405-521-1969).

Location: 13174 N Macarthur Blvd, Oklahoma City, OK, 73196-0317
person
Provider Profile Details
NPI Number
1376526756
Provider Name
Kelly J Walworth
Credential
PAC
Provider Entity Type
Individual
Gender
Female
Address
13174 N Macarthur Blvd, Oklahoma City, OK, 73196-0317
Phone Number
405-721-5555
Fax Number
405-470-7093
Provider Enumeration Date
11/21/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1710198569 01 OK GROUP NPI
200265130A 05 OK
institution
Provider Business Practice Location Address Details
Address
13174 N Macarthur Blvd
City
State
Zip
73142-3017
Phone Number
405-721-5555
Fax Number
405-470-7093
person
Provider Business Mailing Address Details
Address
Dept 96-0317
City
State
Zip
73196-0317
Phone Number
405-521-1969
Fax Number
405-521-1979
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1460 (Oklahoma)
Definition
Definition to come...
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