| Oklahoma West Physicians Group | |
|
579 N Broadway Ave Hydro OK 73048-8425 | |
| (405) 663-2291 | |
| (405) 663-2121 |
| Full Name | Oklahoma West Physicians Group |
|---|---|
| Speciality | Family Medicine |
| Location | 579 N Broadway Ave, Hydro, Oklahoma |
| Authorized Official Name and Position | Brenda R Stutzman (PHYSICIAN) |
| Authorized Official Contact | 4056632291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma West Physicians Group 579 N Broadway Ave Hydro OK 73048-8425 Ph: (405) 663-2291 | Oklahoma West Physicians Group 579 N Broadway Ave Hydro OK 73048-8425 Ph: (405) 663-2291 |
| NPI Number | 1457531600 |
|---|---|
| Provider Enumeration Date | 11/05/2007 |
| Last Update Date | 11/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457531600 | NPI | - | NPPES |
| 446748104001 | Other | OK | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3099 (Oklahoma) | Primary |
Hydro Medical Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 579 N Broadway Ave, Hydro, OK 73048 Phone: 405-663-2291 Fax: 405-663-2191 |