Healthcare Provider Details

I. General information

NPI: 1083653919
Provider Name (Legal Business Name): KENT H WEBB MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SW 44TH ST SUITE 100
OKLAHOMA CITY OK
73109-3630
US

IV. Provider business mailing address

1000 SW 44TH ST STE 200
OKLAHOMA CITY OK
73109-3629
US

V. Phone/Fax

Practice location:
  • Phone: 405-632-4616
  • Fax: 405-631-1550
Mailing address:
  • Phone: 405-632-4616
  • Fax: 405-631-1550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. KENT HARRIS WEBB
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 405-632-4616