Healthcare Provider Details

I. General information

NPI: 1124388855
Provider Name (Legal Business Name): MIDWEST HOSPITAL MEDICINE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 18TH ST
GROVE OK
74344-2907
US

IV. Provider business mailing address

1643 NW 136TH AVE STE 100
SUNRISE FL
33323-2857
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-2243
  • Fax: 918-787-3643
Mailing address:
  • Phone: 800-424-3672
  • Fax: 954-377-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID FRANTZ
Title or Position: PRESIDENT
Credential: MD
Phone: 800-424-3672