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General NPI Number Information
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NPI Number | 1114126331
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Entity Type | Organization
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Legal Business Name | WENDY S BARTANEN MD, PC
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 1102 SE 36TH ST
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City | LAWTON
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State | OK
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Zip | 73501-8462
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Country | US
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Telephone | 580-351-2278
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Fax | 580-353-0462
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Provider Business Mailing Address
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Address Line | 1102 SE 36TH ST
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City | LAWTON
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State | OK
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Zip | 73501-8462
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Country | US
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Telephone | 580-351-2278
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Fax | 580-353-0462
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WENDY S BARTANEN
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Credential | MD, PC
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Telephone | 580-351-2278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20119
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License Number State | OK
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