MR. Robert Eugene Vandiver II, P.A.

NPI #1417090770 in Wilburton, Oklahoma

Provider Information

NPI Number: 1417090770
Entity Type: Individual
Name: MR. Robert Eugene Vandiver II, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Feb 15, 2007
Last Updated: Nov 12, 2007

Practice Location

Address: 139 E MAIN ST
City: Wilburton
State: Oklahoma
ZIP Code: 74578-4229
Phone: (918) 465-5727

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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