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General NPI Number Information
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NPI Number | 1982579660
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Entity Type | Organization
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Legal Business Name | DELO BROTHERS
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 14319 E 500 RD
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City | CLAREMORE
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State | OK
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Zip | 74019-1871
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Country | US
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Telephone | 918-803-1559
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Fax |
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Provider Business Mailing Address
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Address Line | 14319 E 500 RD
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City | CLAREMORE
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State | OK
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Zip | 74019-1871
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WALTER DELONG
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Credential |
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Telephone | 918-803-1559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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