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General NPI Number Information
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NPI Number | 1164181244
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Entity Type | Organization
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Legal Business Name | ACHIEVE HEALTH FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 6922 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-1803
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Country | US
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Telephone | 405-631-0483
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Fax | 405-561-6856
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Provider Business Mailing Address
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Address Line | 6922 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-1803
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Country | US
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Telephone | 405-631-0483
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Fax | 405-561-6856
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Authorized Official
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Title or Position | CMO
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Name | RYAN D WILSON
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Credential | DO
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Telephone | 405-631-0483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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