| Woodward Family Medicine, Pllc | |
|
1024 Main St Woodward OK 73801-3120 | |
| (580) 254-5353 | |
| (580) 254-5354 |
| Full Name | Woodward Family Medicine, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1024 Main St, Woodward, Oklahoma |
| Authorized Official Name and Position | Walter R Klassen (OWNER) |
| Authorized Official Contact | 5802545353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodward Family Medicine, Pllc 1024 Main St Woodward OK 73801-3120 Ph: (580) 254-5353 | Woodward Family Medicine, Pllc 1024 Main St Woodward OK 73801-3120 Ph: (580) 254-5353 |
| NPI Number | 1801175161 |
|---|---|
| Provider Enumeration Date | 08/04/2011 |
| Last Update Date | 02/03/2012 |
| Medicare PECOS PAC ID | 9638336662 |
|---|---|
| Medicare Enrollment ID | O20120202000846 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801175161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 23902 (Oklahoma) | Primary |
| Provider Name | Walter R Klassen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326180084 PECOS PAC ID: 6305999137 Enrollment ID: I20090727000657 |
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