Provider Demographics
NPI:1558666909
Name:HYTCHE, LARRY MARTIN (PA)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:MARTIN
Last Name:HYTCHE
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1705 E 19TH ST
Mailing Address - Street 2:STE 302
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5410
Mailing Address - Country:US
Mailing Address - Phone:918-832-6049
Mailing Address - Fax:918-832-6055
Practice Address - Street 1:1705 E 19TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5405
Practice Address - Country:US
Practice Address - Phone:918-748-7585
Practice Address - Fax:918-748-7539
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2016-09-20
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Provider Licenses
StateLicense IDTaxonomies
OK1975363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant