Healthcare Provider Details

I. General information

NPI: 1881659746
Provider Name (Legal Business Name): BAPTIST HEALTHCARE OF OKLAHOMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 NE 1ST ST
PRYOR OK
74361-8850
US

IV. Provider business mailing address

1301 NE 1ST ST
PRYOR OK
74361-8850
US

V. Phone/Fax

Practice location:
  • Phone: 918-824-7777
  • Fax: 918-824-6414
Mailing address:
  • Phone: 918-824-7777
  • Fax: 918-824-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUGLAS KENT WEAVER
Title or Position: PRESIDENT
Credential:
Phone: 918-825-1600