Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WILLIE J STREET, P.A.-C
Active Sole ProprietorMR. WILLIE J STREET, P.A.-C is a Physician Assistant healthcare provider located in TONKAWA, Oklahoma. NPI 1215005244 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · TONKAWA, OK
Registration Details
- NPI Number
- 1215005244
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 30, 2006 (19.685756968768 yrs)
- Last Updated
- Mar 7, 2012
- License
-
631 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
600 E GRAND AVETONKAWA, OK, 746533545Browse OK providers · Browse ZIP 74653
- Phone
- 5806284800
- Primary Specialty
-
Physician Assistant
363A00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.