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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. WYATT EVANS LIVELY, D.PH.

Active Sole Proprietor

MR. WYATT EVANS LIVELY, D.PH. is a Long-Term Care Pharmacy healthcare provider located in NOWATA, Oklahoma. NPI 1679126627 is currently active in the NPPES registry. Verify at CMS.

Long-Term Care Pharmacy · NOWATA, OK

Registration Details

NPI Number
1679126627
Provider Type
Individual
Gender
Male
NPI Issued
Jul 18, 2019 (7.0643546213564 yrs)
Last Updated
Jul 18, 2019
License
18327 (OK)
Sole Proprietor
Yes

Practice Information

Address
128 E CHEROKEE AVE
NOWATA, OK, 740482702
Browse OK providers · Browse ZIP 74048
Phone
9182733825
Fax
9182732251
Primary Specialty
Long-Term Care Pharmacy
3336C0003X
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.