Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Wyatt Evans Lively, DPH

Individual provider Community/Retail Pharmacy · NPI 1679126627

Mr. Wyatt Evans Lively, DPH is a Community/Retail Pharmacy in Nowata, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2019

Practice location Address checks out

128 E Cherokee Ave
Nowata, OK 74048-2702
Phone: (918) 273-3825
Fax: (918) 273-2251
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 18327 (OK)

Record details

NPI number1679126627
Entity typeIndividual (Type 1)
GenderMale
Credentials DPH
Sole proprietorYes
NPI enumeratedJuly 18, 2019
Last updated in NPPESJuly 18, 2019

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