| Woundynamics Llc | |
|
1601 Sw 89th St Ste A100 Oklahoma City OK 73159-6357 | |
| (206) 465-4313 | |
| Not Available |
| Full Name | Woundynamics Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1601 Sw 89th St Ste A100, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Danh Pham (DO) |
| Authorized Official Contact | 4052251122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woundynamics Llc 1601 Sw 89th St Ste A100 Oklahoma City OK 73159-6357 Ph: (206) 465-4313 | Woundynamics Llc 1601 Sw 89th St Ste A100 Oklahoma City OK 73159-6357 Ph: (206) 465-4313 |
| NPI Number | 1114535333 |
|---|---|
| Provider Enumeration Date | 07/14/2020 |
| Last Update Date | 10/10/2023 |
| Medicare PECOS PAC ID | 7719301449 |
|---|---|
| Medicare Enrollment ID | O20200728000660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114535333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Danh Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932426269 PECOS PAC ID: 7214181379 Enrollment ID: I20130205000069 |
| Provider Name | Jennifer A Hard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558728212 PECOS PAC ID: 7911202023 Enrollment ID: I20160229000753 |
| Provider Name | Michelle R Sturdivant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154873743 PECOS PAC ID: 4183907579 Enrollment ID: I20170209000208 |
| Provider Name | Ashley D Amaireh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801350152 PECOS PAC ID: 2466793005 Enrollment ID: I20190409002834 |
| Provider Name | Heather Dawn Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851823587 PECOS PAC ID: 5395016570 Enrollment ID: I20190814001312 |
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