Provider Demographics
NPI:1871568816
Name:BERRYHILL, WAYNE E (MD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:E
Last Name:BERRYHILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3033 NW 63RD ST
Mailing Address - Street 2:SUITE 152
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3634
Mailing Address - Country:US
Mailing Address - Phone:405-755-6651
Mailing Address - Fax:405-755-2795
Practice Address - Street 1:3650 W ROCK CREEK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2202
Practice Address - Country:US
Practice Address - Phone:405-364-2666
Practice Address - Fax:405-364-9627
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2016-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK23401207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1123401Medicaid
OK1123401Medicaid