Search › Oklahoma › 183500000X
Mitchell Wallis
NPI 1528925104 · on the registry since 2026 · sole proprietor
Practice
- Address
- 802 N Park Dr
Broken Bow, OK 74728 - Phone
- (580) 584-2850
- Fax
- (580) 584-2820
- Organisation at this address
- Simpson Pharmacy, Pllc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-01-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma