Healthcare Provider Details

I. General information

NPI: 1750740338
Provider Name (Legal Business Name): WOODWARD HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 SW 7TH ST
MOORELAND OK
73852-7602
US

IV. Provider business mailing address

417 SW 7TH ST
MOORELAND OK
73852-7602
US

V. Phone/Fax

Practice location:
  • Phone: 580-256-2188
  • Fax:
Mailing address:
  • Phone: 580-256-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES WRIGHT
Title or Position: DIRECTOR
Credential:
Phone: 615-778-1502