Healthcare Provider Details

I. General information

NPI: 1346306644
Provider Name (Legal Business Name): MEDICAL CENTER OF STRATFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W SMITH
STRATFORD OK
74872
US

IV. Provider business mailing address

217 W SMITH
STRATFORD OK
74872
US

V. Phone/Fax

Practice location:
  • Phone: 580-759-2336
  • Fax:
Mailing address:
  • Phone: 580-759-2336
  • 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: MR. RON WAYNE WEBB
Title or Position: CEO
Credential:
Phone: 580-332-2323