Healthcare Provider Details

I. General information

NPI: 1700993797
Provider Name (Legal Business Name): WAPITI ORTHOPEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#1 HOSPITAL DRIVE
MADILL OK
73446
US

IV. Provider business mailing address

PO BOX 632
MADILL OK
73446
US

V. Phone/Fax

Practice location:
  • Phone: 580-795-0216
  • Fax: 580-795-0394
Mailing address:
  • Phone: 580-795-0191
  • Fax: 580-795-0194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY C CUMMING
Title or Position: OWNER
Credential: MD
Phone: 580-795-0191